Type 2 inflammation and cardiometabolic disease in middle-aged adults

Background Asthma has been associated with a higher risk for cardiometabolic disease. One possible explanation is the activation of type 2 inflammation. We aimed to investigate whether there is an association between type 2 inflammation and cardiometabolic disease and whether the association varies between different biomarkers. Methods This cross-sectional study included a total of 4277 non-smoking participants with data on cardiometabolic disease and type 2 inflammation (blood eosinophil count, exhaled nitric oxide fraction (FENO) and IgE sensitisation). The cut-off values of the biomarkers were ≥0.3×109 L−1for blood eosinophil count, ≥25 ppb forFENOand ≥0.35 PAU·L−1for IgE sensitisation. Results There was a higher prevalence of cardiometabolic disease among participants with any type 2 biomarker: diabetes (5.2%versus3.3%; p=0.002), cardiovascular disease (CVD) (3.3%versus1.8%; p=0.002) and hypertension (23.7%versus20.2%; p=0.007). Diabetes had the strongest association with having all three biomarkers elevated (OR 4.03 (95% CI 1.84–8.87)), followed by elevation of both blood eosinophil count andFENO(OR 2.38 (95% CI 1.15–4.91)) and of only blood eosinophil count (2.02 (95% CI 1.21–3.36); p=0.007). CVD was associated with the combination of elevated blood eosinophil count and IgE sensitisation (OR 4.77 (95% CI 2.11–10.79)) and with elevatedFENO(OR 2.57 (95% CI 1.31–5.06)). Hypertension was associated with elevated blood eosinophil count (OR 1.65 (95% CI 1.26–2.18)). Conclusion We found an association between type 2 inflammation and cardiometabolic disorder, but the association with the combination of markers varied between the diseases.