TY - JOUR T1 - Combined value of exhaled nitric oxide and blood eosinophils in chronic airway disease: the Copenhagen General Population Study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00616-2018 SP - 1800616 AU - Yunus Çolak AU - Shoaib Afzal AU - Børge G. Nordestgaard AU - Jacob L. Marott AU - Peter Lange Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/06/07/13993003.00616-2018.abstract N2 - We investigated whether the combination of increased fraction of exhaled nitric oxide (FeNO) level and blood eosinophil count had an additive value in chronic airway disease in the general population.We included 4677 individuals aged 20–100 years from the Copenhagen General Population Study. Based on pre- and post-bronchodilator spirometry, self-reported asthma, and smoking history, participants were subdivided into:healthy never-smokers (n=1649), healthy ever-smokers (n=1581), asthma (n=449), chronic obstructive pulmonary disease (COPD) (n=404), asthma-COPD overlap (ACO) (n=138), and non-specific airflow limitation (n=456).Compared to individuals with FeNO<25 ppb and blood eosinophils<0.3×10−9/L, age- and sex adjusted odds ratios (ORs) for wheezing were 1.54(95% CI:1.29–1.84) for individuals with FeNO≥25 ppb or blood eosinophils≥0.3×10−9/L and 2.14(1.47–3.10) for individuals with FeNO≥25 ppb and blood eosinophils≥0.3×10−9/L. Corresponding ORs were 1.13(0.91–1.41) and 1.83(1.20–2.79) for sputum production, 1.54(1.22–1.94) and 3.26(2.16–4.94) for asthma, 1.03(0.80–1.32) and 0.67(0.36–1.27) for COPD, and 1.32(0.88–1.96) and 2.14(1.05–4.36) for ACO. Among individuals reporting respiratory symptoms, predicting the type of chronic airway disease did not differ between the two biomarkers and did not improve by combining them.Combination of FeNO and blood eosinophils may have an additive value in characterising chronic airway disease in the general population but still needs to be investigated further with regard to clinical application.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Çolak reports personal fees from Boehringer Ingelheim and AstraZeneca outside the submitted work.Conflict of interest: Dr. Afzal has nothing to disclose.Conflict of interest: Dr. Nordestgaard has nothing to disclose.Conflict of interest: Mr. Marott has nothing to disclose.Conflict of interest: Dr. Lange reports personal fees from Boehringer Ingelheim, grants and personal fees from Astra Zeneca, personal fees from Novartis, grants and personal fees from GSK, outside the submitted work; . ER -