title: Eosinophilia is associated with increased all-cause mortality after a follow-up of 30 years in a general population sample.
abstract: We investigated whether allergy is associated with increased all-cause mortality. Two allergy markers, peripheral blood eosinophilia (> or =275 eosinophilic cells per mm3) and positive skin tests (sum score > or =3), were available for 5,383 subjects of a cohort study on asthma and chronic obstructive pulmonary disease in general population samples of Vlagtwedde and Vlaardingen, the Netherlands, in 1965-1972. During 30 years of follow-up, 1,135 subjects died. In a Cox regression analysis, eosinophilia was associated with an increased risk (relative risk = 1.4; 95% confidence interval = 1.2-1.7) of all-cause mortality, independent of gender, age, smoking habits, percentage predicted forced expiratory volume in 1 second (FEV1 % predicted), and positive skin tests at the start of the study. Subjects with positive skin tests had only an increased risk of all-cause mortality in the subgroup of subjects with FEV1 <80% of predicted (relative risk = 1.7; 95% confidence interval = 1.0-2.8). These results remained essentially unchanged after exclusion of subjects with asthma. We conclude that eosinophilia is associated with increased all-cause mortality. An increased number of peripheral blood eosinophils may reflect an increased inflammatory response, resulting in tissue injury. It is possible that the association between a low FEV1% predicted and all-cause mortality is partly mediated by an atopic constitution.
authors.affiliation: Department of Epidemiology and Statistics, University of Groningen, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Hospers
authors.forename: J P
authors.initials: JP
authors.lastname: Schouten
authors.forename: S T
authors.initials: ST
authors.lastname: Weiss
authors.forename: D S
authors.initials: DS
authors.lastname: Postma
authors.forename: B
authors.initials: B
authors.lastname: Rijcken
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D004802:Eosinophilia / Q000150:complications / Q000276:immunology / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D006967:Hypersensitivity / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D016019:Survival Analysis