JESREC score, metabolic factors, and pulmonary dysfunction: analysis among adult patients with chronic rhinosinusitis

Chronic Rhinosinusitis (CRS), particularly its eosinophilic endotype (ECRS), is frequently associated with comorbid lower airway diseases. The JESREC score is a clinical tool for predicting ECRS. This study aimed to evaluate the association between the JESREC score and pulmonary dysfunction in adult CRS patients and to explore the potential role of metabolic factors.

Patients were categorized based on pulmonary function tests and multivariate logistic regression analyses were performed to identify associated factors for overall pulmonary dysfunction and its restrictive and obstructive subtypes. The discriminative ability of the JESREC score was evaluated using Receiver Operating Characteristic (ROC) curve analysis. Furthermore, mediation models were constructed to figure out the mediating role of metabolic factors (BMI, blood pressure, fasting blood glucose and serum lipidomic profiles).

A total of 143 patients were included in the final analysis. The JESREC score was significantly higher in patients with pulmonary dysfunction (8.6 vs. 5.0, P < 0.001). Multivariate analysis confirmed the JESREC score (OR, 1.24, 95% CI, 1.12-1.37) and ECRS (5.17, 2.05-13.09) as associated factors for pulmonary dysfunction, including both restrictive and obstructive subtypes. The ROC curve showed an AUC of 0.729, with an optimal JESREC cutoff of 4.5. Mediation analysis indicated that systolic blood pressure, diastolic blood pressure, triglycerides, and HDL-C significantly mediated 6.4%, 4.5%, 8.4%, and 6.5% of the total effect, respectively.

JESREC score was independently associated with pulmonary dysfunction in CRS patients, and metabolic factors may statistically mediate part of this association, suggesting a potential pathway. Furthermore, patients with JESREC score ≥ 5 may warrant special attention to pulmonary function.