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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 ,0.3x109 L-1 for blood eosinophil count, ,25 ppb for FENO and ,0.35 PAU<middle dot>L-1 for IgE sensitisation.

Results: There was a higher prevalence of cardiometabolic disease among participants with any type 2 biomarker: diabetes (5.2% versus 3.3%; p=0.002), cardiovascular disease (CVD) (3.3% versus 1.8%; p=0.002) and hypertension (23.7% versus 20.2%; 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 and FENO (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 elevated FENO (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.