DataSheet_1_Associations of complete blood cell count-derived inflammatory biomarkers with asthma and mortality in adults: a population-based study.docx

ObjectiveThis study aims to assess the associations of complete blood cell count (CBC)-derived inflammatory biomarkers with the prevalence of asthma and mortality.
MethodsData was collected from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Mortality was identified using the National Death Index until December 31, 2019. The study analyzed the relationship between CBC-derived inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index (SII), and the prevalence of asthma using multiple logistic regressions. To assess the significance of CBC-derived inflammatory biomarkers in predicting all-cause and respiratory disease mortality in asthma patients, Cox proportional regressions and the random survival forest (RSF) analysis were utilized.
ResultsA total of 48,305 participants were included, with a mean age of 47.27 ± 0.18 years and 49.44% male. Among them, 6,403 participants had asthma, with a prevalence of 13.28%. The all-cause and respiratory disease deaths at a median follow-up of 8.2 (4.5, 12.8) years were 929 and 137 respectively. After adjusting for confounders, the prevalence of asthma was found to be positively associated with NLR, PLR, MLR, SIRI and SII. Compared to the lowest quartile, the highest quartile of NLR (HR=1.765 [1.378-2.262]), MLR (HR=1.717 [1.316-2.241]), SIRI (HR=1.796 [1.353-2.383]) and SII (HR=1.432 [1.141-1.797]) were associated with an increased risk of all-cause mortality. These associations were more pronounced in respiratory disease mortality of asthma patients. RSF analysis showed that MLR had the highest predictive value for all-cause and respiratory disease mortality in adults with asthma. The sensitivity analysis demonstrated the stability of our results.
ConclusionThe findings suggest that CBC-derived inflammatory biomarkers are associated with a higher risk of all-cause and respiratory disease mortality in adults with asthma.

研究目的：本研究旨在评估全血细胞计数（complete blood cell count, CBC）衍生的炎症生物标志物与哮喘患病率及死亡率的关联。
研究方法：本研究数据取自1999-2018年全国健康与营养调查（National Health and Nutrition Examination Survey, NHANES）。以国家死亡索引追踪至2019年12月31日以确定研究对象的死亡情况。本研究采用多重logistic回归分析，探讨全血细胞计数衍生的炎症生物标志物——包括中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte ratio, NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio, PLR）、单核细胞与淋巴细胞比值（monocyte-to-lymphocyte ratio, MLR）、全身炎症反应指数（systemic inflammatory response index, SIRI）以及全身免疫炎症指数（systemic immune-inflammation index, SII）——与哮喘患病率之间的关联。为评估全血细胞计数衍生的炎症生物标志物对哮喘患者全因死亡及呼吸系统疾病死亡的预测价值，本研究采用Cox比例风险回归及随机生存森林（random survival forest, RSF）分析方法。
研究结果：本研究共纳入48305名研究对象，平均年龄为47.27±0.18岁，男性占比49.44%。其中6403名研究对象罹患哮喘，哮喘患病率为13.28%。中位随访时间为8.2（四分位间距4.5~12.8）年，期间全因死亡929例，呼吸系统疾病死亡137例。经混杂因素校正后，哮喘患病率与NLR、PLR、MLR、SIRI及SII均呈正相关。与最低四分位组相比，NLR最高四分位组（HR=1.765，95%置信区间1.378~2.262）、MLR最高四分位组（HR=1.717，95%置信区间1.316~2.241）、SIRI最高四分位组（HR=1.796，95%置信区间1.353~2.383）及SII最高四分位组（HR=1.432，95%置信区间1.141~1.797）的全因死亡风险均显著升高。上述关联在哮喘患者的呼吸系统疾病死亡中更为显著。随机生存森林分析显示，MLR对成人哮喘患者的全因死亡及呼吸系统疾病死亡具有最高的预测价值。敏感性分析证实了本研究结果的稳定性。
研究结论：本研究结果表明，全血细胞计数衍生的炎症生物标志物与成人哮喘患者更高的全因死亡及呼吸系统疾病死亡风险相关。