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Cannon MF, Goldfarb DG, Zeig-Owens RA, Hall CB, Choi J, Cohen HW, Prezant DJ, Weiden MD. Normal Lung Function and Mortality in World Trade Center Responders and National Health and Nutrition Examination Survey III Participants. Am J Respir Crit Care Med 2024; 209:1229-1237. [PMID: 38163381 DOI: 10.1164/rccm.202309-1654oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
Rationale: Low FEV1 is a biomarker of increased mortality. The association of normal lung function and mortality is not well described. Objectives: To evaluate the FEV1-mortality association among participants with normal lung function. Methods: A total of 10,999 Fire Department of the City of New York (FDNY) responders and 10,901 Third National Health and Nutrition Examination Survey (NHANES III) participants, aged 18-65 years with FEV1 ⩾80% predicted, were analyzed, with FEV1 percent predicted calculated using Global Lung Function Initiative Global race-neutral reference equations. Mortality data were obtained from linkages to the National Death Index. Cox proportional hazards models estimated the association between FEV1 and all-cause mortality, controlling for age, sex, race/ethnicity, smoking history, and, for FDNY, work assignment. Cohorts were followed for a maximum of 20.3 years. Measurements and Main Results: We observed 504 deaths (4.6%) of 10,999 for FDNY and 1,237 deaths (9.4% [weighted]) of 10,901 for NHANES III. Relative to FEV1 ⩾120% predicted, mortality was significantly higher for FEV1 100-109%, 90-99%, and 80-89% predicted in the FDNY cohort. In the NHANES III cohort, mortality was significantly higher for FEV1 90-99% and 80-89% predicted. Each 10% higher predicted FEV1 was associated with 15% (hazard ratio, 0.85; 95% confidence interval, 0.80-0.91) and 23% (hazard ratio, 0.77; 95% confidence interval, 0.71-0.84) lower mortality for FDNY and NHANES III, respectively. Conclusions: In both cohorts, higher FEV1 is associated with lower mortality, suggesting higher FEV1 is a biomarker of better health. These findings demonstrate that a single cross-sectional measurement of FEV1 is predictive of mortality over two decades, even when FEV1 is in the normal range.
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Affiliation(s)
- Madeline F Cannon
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
| | - David G Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Rachel A Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Jaeun Choi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Hillel W Cohen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - David J Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Michael D Weiden
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- New York University Grossman School of Medicine, New York, New York
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Rydell A, Janson C, Lisspers K, Lin YT, Ärnlöv J. FEV 1 and FVC as robust risk factors for cardiovascular disease and mortality: Insights from a large population study. Respir Med 2024; 227:107614. [PMID: 38670319 DOI: 10.1016/j.rmed.2024.107614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Data is limited on influence of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in a large adult population, including individuals with normal spirometry at baseline. METHODS Using the UK Biobank cohort, a multivariable Cox regression analysis was conducted on 406,424 individuals to examine the association between FEV1 and FVC, categorized into three groups based on their percentage of predicted values (%pred) (≥80, 60-80 and < 60), and overall mortality, cardiovascular mortality, myocardial infarction, stroke, and heart failure over approximately 12.5 years. Moreover, a subgroup analysis was conducted on 295,459 individuals who had normal spirometry. RESULTS Reduced FEV1 and FVC %pred values were associated with an elevated risk across all studied outcomes. Individuals with the lowest FEV1 and FVC %pred values (<60 %) exhibited HR of 1.83 (95 % CI 1.74-1.93) and 1.98 (95 % CI 1.76-2.22) for overall mortality, and 1.96 (95 % CI 1.83-2.1) and 2.26 (95 % CI 1.94-2.63) for cardiovascular mortality. Moreover, a graded association was observed between lower FEV1 and FVC %pred, even among never smokers and individuals with normal spirometry at baseline. DISCUSSION Reduced FEV1 and FVC represent robust risk factors for cardiovascular disease and mortality. The fact that the increased risk was evident also at FEV1 and FVC levels exceeding 80 %pred challenges the contemporary classification of lung function categories and the notion that the entire FEV1- and FVC-range above 80 % of predicted represents a normal lung function.
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Affiliation(s)
- Andreas Rydell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden; Centrum För Klinisk Forskning, Region Dalarna, Falun, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University, Uppsala, Sweden
| | - Karin Lisspers
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Yi-Ting Lin
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden
| | - Johan Ärnlöv
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden; Centrum För Klinisk Forskning, Region Dalarna, Falun, Sweden; School of Health and Welfare, Dalarna University, Falun, Sweden
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Hamao N, Ito I, Oi I, Shirata M, Nishioka K, Hayashi Y, Imai S, Hirai T. Clinical phenotypes of nontuberculous mycobacterial disease by cluster analysis based on pulmonary function. Respir Med 2024; 225:107600. [PMID: 38490432 DOI: 10.1016/j.rmed.2024.107600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/03/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Nontuberculous mycobacterial pulmonary disease (NTM-PD) often exhibits pulmonary function impairment, such as obstructive or restrictive pattern, with variation among patients according to the damaged lesions in the lung. METHODS Patients with NTM-PD were consecutively enrolled between September 2019 and December 2020 at the Respiratory Infection Clinic of our hospital. Patients' data were comprehensively collected through laboratory examinations, PFT, chest computed tomography, and questionnaires for the assessment of subjective symptoms and health-related quality of life (HRQOL). Hierarchical cluster analysis was performed using PFT parameters to compare the clinical findings among clusters. RESULTS Data of 104 patients were analyzed and classified into four clusters. The restrictive pattern with decreased forced expiratory volume in 1 s (FEV1) group showed high serum C-reactive protein and low albumin levels, severe radiological findings, and low HRQOL. In the restrictive pattern with preserved FEV1 group, HRQOL was as low as that in the restrictive pattern with decreased FEV1 group, and bacterial exacerbation was observed relatively frequently. HRQOL in the obstructive impairment group was maintained in comparison with that in the normal group. CONCLUSION NTM-PD phenotypes were identified using cluster analysis based on PFT. Two different severe phenotypes were also observed. In the early stages of NTM-PD, PFT may be useful in recognizing disease progression.
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Affiliation(s)
- Nobuyoshi Hamao
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
| | - Isao Ito
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan.
| | - Issei Oi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
| | - Masahiro Shirata
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
| | - Kensuke Nishioka
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
| | - Yasuyuki Hayashi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
| | - Seiichiro Imai
- Kyoto University Hospital Preemptive Medicine and Lifestyle-Related Disease Research Center, 53 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawaracho, Sakyo, Kyoto, 606-8507, Japan
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Takase M, Yamada M, Nakamura T, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Chiba I, Kanno I, Nochioka K, Tsuchiya N, Hirata T, Hamanaka Y, Sugawara J, Kobayashi T, Fuse N, Uruno A, Kodama EN, Kuriyama S, Tsuji I, Hozawa A. Combined Fat Mass and Fat-free Mass Indices and Lung Function Among Japanese Population: The Tohoku Medical Megabank Community-based Cohort Study. J Epidemiol 2024; 34:119-128. [PMID: 37032111 PMCID: PMC10853044 DOI: 10.2188/jea.je20220355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Although fat mass index (FMI) and fat-free mass index (FFMI) affect lung function, FMI and FFMI are not independent of each other, since FMI and FFMI were calculated as fat mass and fat-free mass divided by height squared, respectively. We aimed to examine the association of combined FMI and FFMI with lung function. METHODS In this cross-sectional study, lung function was evaluated using forced expiratory volume at 1 s (FEV1) and forced vital capacity (FVC) measured using spirometry. Both FMI and FFMI were classified into sex-specific quartiles (16 groups). Analysis of covariance was used to assess the associations of combined FMI and FFMI with lung function. The trend test was conducted by stratifying the FMI and FFMI, scoring the categories from 1-4 (lowest-highest), and entering the number as a continuous term in the regression model. RESULTS This study included 3,736 men and 8,821 women aged ≥20 years living in Miyagi Prefecture, Japan. The mean FEV1 was 3.0 (standard deviation [SD], 0.7) L for men and 2.3 (SD, 0.5) L for women. The mean FVC was 3.8 (SD, 0.7) L for men and 2.8 (SD, 0.5) L for women. FMI was inversely associated with lung function among all FFMI subgroups in both sexes. Conversely, FFMI was positively associated with lung function in all FMI subgroups in both sexes. CONCLUSION Higher FMI was associated with lower lung function independent of FFMI; higher FFMI was associated with higher lung function independent of FMI. Reducing FMI and maintaining FFMI might be important for respiratory health.
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Affiliation(s)
- Masato Takase
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | | | - Tomohiro Nakamura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ippei Chiba
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eiichi N. Kodama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Ichiro Tsuji
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
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Tang Y, Zhang L, Zhu S, Shen M, Cheng M, Peng F. Associations between different body mass index and lung function impairment in Chinese people aged over 40 years: a multicenter cross-sectional study. BMC Pulm Med 2024; 24:30. [PMID: 38212744 PMCID: PMC10785338 DOI: 10.1186/s12890-024-02844-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore the associations between different body mass index (BMI) levels and different lung function impairment (LFI) in Chinese people aged over 40 years. METHODS We used a multi-stage stratified cluster random sampling method to investigate 3000 residents aged over 40 years from 5 areas in Hubei province of China in 2019-20. The data on questionnaire, physical measurements, and spirometry of the participants were collected. The associations of different BMI levels with different LFI were analyzed using multivariate logistic regressions after complex weighting. The spirometry data were analyzed using one-factor analysis of variance (ANOVA), and post-hoc was performed using the least significance difference (LSD)-t test. RESULTS A total of 2860 subjects were included. The prevalence (95%CI) of obstructive lung disease (OLD), restrictive lung disease (RLD), mixed lung disease (MLD), chronic obstructive pulmonary disease (COPD), COPD mild, and COPD moderate/severe/very severe were 24.1% (95% CI: 22.2-26.2), 11.6% (95% CI: 10.3-12.9), 4.0% (95% CI: 3.3-4.8), 12.6% (95% CI: 11.0-14.1), 7.2% (95% CI: 6.0-8.4), and 5.3% (95% CI: 4.3-6.4) respectively. After multivariate adjustment, the risk of OLD, COPD, and COPD mild decreased with the increment of BMI levels (both P for trend < 0.05). When compared to the normal weight group, the overweight group and obese group were at lower risk of experiencing OLD than normal group, the ORs were 0.77 (95% CI: 0.59-0.99) and 0.59 (95% CI: 0.40-0.86) respectively. The obese group was at lower risk for people with COPD mild (OR: 0.42, 95%CI: 0.21-0.85). Participants in underweight group were more likely to experience COPD and COPD moderate/severe/very severe, the ORs were 2.82 (95% CI: 1.07-7.39) and 3.89 (95% CI: 1.28-11.87) respectively. CONCLUSION Higher BMI levels were associated with an decreased risk of OLD and COPD. Obesity had a protective effect on lung function in OLD patients and COPD patients. However, there was no significant difference in RLD and MLD prevalence between different BMI groups.
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Affiliation(s)
- Yumeng Tang
- Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - Lan Zhang
- Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - Shuzhen Zhu
- Hubei Provincial Center for Disease Control and Prevention, Hubei, China.
| | - Miaoyan Shen
- Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - Maowei Cheng
- Hubei Provincial Center for Disease Control and Prevention, Hubei, China
| | - Fei Peng
- Hubei Provincial Center for Disease Control and Prevention, Hubei, China.
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Smith EF, Hemy NR, Hall GL, Wilson AC, Murray CP, Simpson SJ. Risk factors for poorer respiratory outcomes in adolescents and young adults born preterm. Thorax 2023; 78:1223-1232. [PMID: 37208189 DOI: 10.1136/thorax-2022-219634] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/23/2023] [Indexed: 05/21/2023]
Abstract
RATIONALE The respiratory outcomes for adult survivors of preterm birth in the postsurfactant era are wide-ranging with prognostic factors, especially those encountered after the neonatal period, poorly understood. OBJECTIVES To obtain comprehensive 'peak' lung health data from survivors of very preterm birth and identify neonatal and life-course risk factors for poorer respiratory outcomes in adulthood. METHODS 127 participants born ≤32 weeks gestation (64%, n=81 with bronchopulmonary dysplasia (BPD), initially recruited according to a 2 with-BPD:1 without-BPD strategy), and 41 term-born controls completed a lung health assessment at 16-23 years, including lung function, imaging and symptom review. Risk factors assessed against poor lung health included neonatal treatments, respiratory hospitalisation in childhood, atopy and tobacco smoke exposure. MEASUREMENTS AND MAIN RESULTS Young adults born prematurely had greater airflow obstruction, gas trapping and ventilation inhomogeneity, in addition to abnormalities in gas transfer and respiratory mechanics, compared with term. Beyond lung function, we observed greater structural abnormalities, respiratory symptoms and inhaled medication use. A previous respiratory admission was associated with airway obstruction; mean forced expiratory volume in 1 s/forced vital capacity z-score was -0.561 lower after neonatal confounders were accounted for (95% CI -0.998 to -0.125; p=0.012). Similarly, respiratory symptom burden was increased in the preterm group with a respiratory admission, as was peribronchial thickening (6% vs 23%, p=0.010) and bronchodilator responsiveness (17% vs 35%, p=0.025). Atopy, maternal asthma and tobacco smoke exposure did not influence lung function or structure at 16-23 years in our preterm cohort. CONCLUSIONS Even after accounting for the neonatal course, a respiratory admission during childhood remained significantly associated with reduced peak lung function in the preterm-born cohort, with the largest difference seen in those with BPD. A respiratory admission during childhood should, therefore, be considered a risk factor for long-term respiratory morbidity in those born preterm, especially for individuals with BPD.
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Affiliation(s)
- Elizabeth F Smith
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Naomi R Hemy
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Graham L Hall
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Andrew C Wilson
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Conor P Murray
- Medical Imaging, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Shannon J Simpson
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Zhao X, Xu W, Gu Y, Li Z, Sun G. Causal associations between hand grip strength and pulmonary function: a two-sample Mendelian randomization study. BMC Pulm Med 2023; 23:459. [PMID: 37990169 PMCID: PMC10664596 DOI: 10.1186/s12890-023-02720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Several observational studies have reported an association between hand grip strength (HGS) and pulmonary function (PF). However, causality is unclear. To investigate whether HGS and PF are causally associated, we performed Mendelian randomization (MR) analyses. METHODS We identified 110 independent single nucleotide polymorphisms (SNPs) for right-hand grip strength (RHGS) and 103 independent SNPs for left-hand grip strength (LHGS) at the genome-wide significant threshold (P < 5 × 10-8) from MRC-IEU Consortium and evaluated these related to PF. MR estimates were calculated using the inverse-variance weighted (IVW) method and multiple sensitivity analyses were further performed. RESULTS Genetical liability to HGS was positively causally associated with forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), but not with FEV1/FVC. In addition, there was positive causal association between RHGS and FVC (OR=1.519; 95% CI, 1.418-1.627; P=8.96E-33), and FEV1 (OR=1.486; 95% CI, 1.390-1.589; P=3.19E-31); and positive causal association between LHGS and FVC (OR=1.464; 95% CI, 1.385-1.548; P=2.83E-41) and FEV1 (OR=1.419; 95% CI, 1.340-1.502; P=3.19E-33). Nevertheless, no associations were observed between RHGS and FEV1/FVC (OR=0.998; 95% CI, 0.902-1.103; P=9.62E-01) and between LHGS and FEV1/FVC (OR=0.966; 95% CI, 0.861-1.083; P=5.52E-01). Similar results were shown in several sensitivity analyses. CONCLUSION Our study provides support at the genetic level that HGS is positively causally associated with FVC and FEV1, but not with FEV1/FVC. Interventions for HGS in PF impairment deserve further exploration as potential indicators of PF assessment.
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Affiliation(s)
- Xianghu Zhao
- College of Sports Medicine, Wuhan Sports University, Wuhan, 430079, Hubei Province, China
- Department of Rehabilitation, Zhongda Hospital, Southeast University, Nanjing, 210009, Jiangsu Province, China
| | - Wenyuan Xu
- Graduate School, Anhui University of Chinese Medicine, Hefei, 230012, Anhui Province, China
| | - Yanchao Gu
- College of Sports Medicine, Wuhan Sports University, Wuhan, 430079, Hubei Province, China
| | - Zhanghua Li
- Department of Orthopedics, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, 430074, Hubei Province, China.
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, 210009, Jiangsu Province, China.
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González-Islas D, Robles-Hernández R, Flores-Cisneros L, Orea-Tejeda A, Galicia-Amor S, Hernández-López N, Valdés-Moreno MI, Sánchez-Santillán R, García-Hernández JC, Castorena-Maldonado A. Association between muscle quality index and pulmonary function in post-COVID-19 subjects. BMC Pulm Med 2023; 23:442. [PMID: 37968677 PMCID: PMC10652568 DOI: 10.1186/s12890-023-02745-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The SARS-CoV2 pandemic impacted many critically ill patients, causing sequelae, affecting lung function, and involving the musculoskeletal system. We evaluated the association between lung function and muscle quality index in severely ill post-COVID-19 patients. METHODS A cross-sectional study was conducted on a post-COVID-19 cohort at a third-level center. The study included patients who had experienced severe-to-critical COVID-19. Anthropometric measurements, such as body mass index (BMI) and handgrip strength, were obtained to calculate the muscle quality index (MQI). Additionally, spirometry, measurements of expiratory and inspiratory pressure, and an assessment of DLCO in the lungs were performed. The MQI was categorized into two groups: low-MQI (below the 50th percentile) and high-MQI (above the 50th percentile), based on sex. Group differences were analyzed, and a multivariate linear regression analysis was performed to assess the association between respiratory function and MQI. RESULTS Among the 748 patients analyzed, 61.96% required mechanical ventilation, and the median hospital stay was 17 days. In patients with a low MQI, it was observed that both mechanical respiratory function and DLCO were lower. The multivariate analysis revealed significantly lower findings in mechanical respiratory function among patients with a low MQI. CONCLUSION The Low-MQI is an independent predictor associated with pulmonary function parameters in subjects with Post-COVID-19 syndrome.
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Affiliation(s)
- Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Robinson Robles-Hernández
- Department of Research in Tobacco Smoking and COPD at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Laura Flores-Cisneros
- Department of Epidemiological Information Analysis at Dirección General de Epidemiología, Secretaría de Salud, Gobierno de México, Mexico City, 01480, Mexico
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico.
| | - Susana Galicia-Amor
- Pulmonary Rehabilitation Department at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Nadia Hernández-López
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Mariana I Valdés-Moreno
- Licenciatura en Nutriología Facultad de Estudios Superiores Zaragoza Universidad Nacional Autónoma de México, C.P. 09230, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Juan Carlos García-Hernández
- Pulmonary Rehabilitation Department at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Armando Castorena-Maldonado
- Direction for Medical Care in Pneumology at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas"|, Mexico City, Mexico
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Pi YY, Hu WX, Jiao ZM, Hou PY, Zhang YH, Zhao Y, Li XX, Yu J, Chen F, Jing JY, Wang FX. Relationship between body composition and pulmonary function in the general population-a cross-sectional study in Ningxia. Sci Rep 2023; 13:17877. [PMID: 37857639 PMCID: PMC10587154 DOI: 10.1038/s41598-023-44486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
Studies considering the relationship between non-obesity-related body composition and lung function are few; therefore, this study aimed to explore these correlations and effects. This cross-sectional study conducted in rural Qingtongxia City and Pingluo County, Ningxia, China, included 776 participants aged 30-75 years. Body composition and lung function were measured using direct segmental multifrequency bioelectrical impedance analysis and a digital spirometer, respectively. Their correlation was assessed using partial correlation analysis, controlling for age and smoking status, and the body composition effect on lung function was analyzed using binomial logistic regression analysis. The body components total body water content, protein content, mineral content, muscle mass, fat-free mass (FFM), skeletal muscle mass, basal metabolic volume, and chest circumference (CC) positively correlated with pulmonary function (forced vital capacity and forced expiratory volume in one second) in both sexes. Neck circumference and hip circumference positively correlated with pulmonary function in women. Additionally, lung function declines more slowly in women (odds ratio [OR] = 0.66, 95% confidence interval [CI] = 0.44-0.98, p = 0.04); CC (OR = 0.92, 95% CI = 0.86-0.98, p = 0.01) increased as a protective factor for decreased lung function. Increased waist circumference (OR = 1.04, 95% CI = 1.00-1.09, p = 0.04) was a risk factor for reduced lung function. FFM contains body composition indicators positively correlating with lung function, excluding fat-related body composition. Abdominal obesity increases the risk of decreased lung function.
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Affiliation(s)
- Yang-Yang Pi
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Wen-Xuan Hu
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Zi-Ming Jiao
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Peng-Yi Hou
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Yu-Hong Zhang
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Yi Zhao
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Xiao-Xia Li
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Jing Yu
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Fang Chen
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Jin-Yun Jing
- Ningxia Hui Autonomous Region Maternal and Child Health Care Hospital, Yinchuan, 750004, People's Republic of China
| | - Fa-Xuan Wang
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China.
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China.
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10
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Santoso A, Rasiha R, Zainal ATF, Khairunnisa IN, Fais MK, Gunawan AMAK. Transforming growth factor-β and matrix metalloproteinases as potential biomarkers of fibrotic lesions induced by tuberculosis: a systematic review and meta-analysis. BMJ Open 2023; 13:e070377. [PMID: 37827747 PMCID: PMC10583088 DOI: 10.1136/bmjopen-2022-070377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/26/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES Very few studies and limited information are available regarding the mechanism of fibrosis in tuberculosis (TB). This study aimed to identify, describe and synthesise potential biomarkers of the development of tissue fibrosis induced by TB through a systematic method and meta-analysis. METHODS A literature search was performed using keywords according to the topic from electronic databases (ScienceDirect and PubMed) and other methods (websites, organisations and citations). Studies that matched predetermined eligibility criteria were included. The quality assessment tool used was the Quality Assessment of Diagnostic Accuracy Score 2, and the data obtained were processed using Review Manager V.5.3. RESULTS Of the 305 studies, 7 met the eligibility criteria with a total sample of 365. The results of the meta-analysis showed that the post-TB group of patients with pulmonary parenchymal fibrosis had a higher transforming growth factor (TGF)-β level (6.09) than the control group (1.82), with a 4.27 (95% CI: 0.92 to 7.61) mean difference. Moreover, patients with residual pleural thickening post-TB had a higher mean of TGF-β (0.61) than the control group (0.56), with a 0.05 (95% CI: 0.04 to 0.06) mean difference. Besides TGF-β, our qualitative synthesis also found that matrix metalloproteinase-1 might have a role in forming and developing pulmonary tissue fibrosis, thus, could be used as a predictor marker in the formation of fibrotic lesions in patients with TB. In addition, several other biomarkers were assessed in the included studies, such as tumour necrosis factor-α, interleukin (IL)-4, IL-8, IL-10, plasminogen activator inhibitor-1 and platelet-derived growth factor. However, this study is not intended to examine these biomarkers. CONCLUSIONS There were differences in the results of TGF-β levels in patients with fibrotic lesions compared with controls. TGF-β might be a biomarker of fibrotic tissue formation or increased pulmonary tissue fibrosis in post-TB patients. However, further studies are needed on a larger scale.
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Affiliation(s)
- Arif Santoso
- Department of Pulmonology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Rasiha Rasiha
- Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
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11
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Orea-Tejeda A, Robles-Hernández R, González-Islas D, Jimenez-Gallardo L, Gochicoa-Rangel L, Castorena-Maldonado A, Hernández-Zenteno R, Montañez-Orozco A, Valderrábano-Salas B. Dynapenia and Sarcopenia in Post-COVID-19 Syndrome Hospitalized Patients Are Associated with Severe Reduction in Pulmonary Function. J Clin Med 2023; 12:6466. [PMID: 37892604 PMCID: PMC10607104 DOI: 10.3390/jcm12206466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND After hospital discharge, post-COVID-19 syndrome has been observed to be associated with impaired diffusing capacity, respiratory muscle strength, and lung imaging abnormalities, in addition to loss of muscle mass/strength, sarcopenia, and obesity impact exercise tolerance, pulmonary functions, and overall prognosis. However, the relationship between lung function and the coexistence of obesity with low muscle strength and sarcopenia in post-COVID-19 patients remains poorly investigated. Therefore, our aim was to evaluate the association between lung function and the coexistence of obesity with dynapenia and sarcopenia in post-COVID-19 syndrome patients. METHODS This cross-sectional study included subjects who were hospitalized due to moderate to severe COVID-19, as confirmed by PCR testing. Subjects who could not be contacted, declined to participate, or died before the follow-up visit were excluded. RESULTS A total of 711 subjects were evaluated; the mean age was 53.64 ± 13.57 years, 12.4% had normal weight, 12.6% were dynapenic without obesity, 8.3% had sarcopenia, 41.6% had obesity, 21.2% had dynapenic obesity, and 3.8% had sarcopenic obesity. In terms of pulmonary function, the dynapenic subjects showed decreases of -3.45% in FEV1, -12.61 cmH2O in MIP, and -12.85 cmH2O in MEP. On the other hand, the sarcopenic subjects showed decreases of -6.14 cmH2O in MIP and -11.64 cmH2O in MEP. The dynapenic obesity group displayed a reduction of -12.13% in PEF. CONCLUSIONS In post-COVID-19 syndrome, dynapenia and sarcopenia-both with and without obesity-have been associated with lower lung function.
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Affiliation(s)
- Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Robinson Robles-Hernández
- Department of Research in Tobacco Smoking and COPD at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” 2, Mexico City 14080, Mexico;
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Luz Jimenez-Gallardo
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Laura Gochicoa-Rangel
- Department of Pulmonary Physiology at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Armando Castorena-Maldonado
- Direction for Medical Care in Pneumology at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” 4, Mexico City 14080, Mexico
| | - Rafael Hernández-Zenteno
- COPD Clinic at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Alvaro Montañez-Orozco
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Benigno Valderrábano-Salas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
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12
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Abstract
Menopause marks the end of the reproductive phase of life. Based on epidemiological studies, abnormal age at natural menopause (ANM) is thought to contribute to a number of adverse outcomes, such as osteoporosis, cardiovascular disease, and cancer. However, the causality of these associations remains unclear. A powerful epidemiological method known as Mendelian randomization (MR) can be used to clarify the causality between ANM and other diseases or traits. The present review describes MR studies that included ANM as an exposure, outcome and mediator. The findings of MR analyses on ANM have revealed that higher body mass index, poor educational level, early age at menarche, early age at first live birth, early age at first sexual intercourse, and autoimmune thyroid disease appear to be involved in early ANM etiology. The etiology of late ANM appears to be influenced by higher free thyroxine 4 and methylene tetrahydrofolate reductase gene mutations. Furthermore, early ANM has been found to be causally associated with an increased risk of osteoporosis, fracture, type 2 diabetes mellitus, glycosylated hemoglobin, and the homeostasis model of insulin resistance level. In addition, late ANM has been found to be causally associated with an increased systolic blood pressure, higher risk of breast cancer, endometrial cancer, endometrioid ovarian carcinoma, lung cancer, longevity, airflow obstruction, and lower risk of Parkinson's disease. ANM is also a mediator for breast cancer caused by birth weight and childhood body size. However, due to the different instrumental variables used, some results of studies are inconsistent. Future studies with more valid genetic variants are needed for traits with discrepancies between MRs or between MR and other types of epidemiological studies.
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Affiliation(s)
- Xiao Zhang
- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhao Huangfu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shaowei Wang
- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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13
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Ohe T, Yamada M, Hozawa A, Nakaya N, Nakamura T, Tsuchiya N, Narita A, Kogure M, Fuse N, Kuriyama S, Mitsune A, Suzuki A, Matsumoto S, Hatakeyama T, Iwasaki C, Suzuki M, Fujino N, Numakura T, Ichikawa T, Koarai A, Tamada T, Yamamoto M, Ichinose M, Sugiura H. Associations between birth weight and lung function in a Japanese adult population: The tohoku medical megabank community-based cohort study. Respir Investig 2023; 61:588-600. [PMID: 37429072 DOI: 10.1016/j.resinv.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/27/2023] [Accepted: 06/05/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Birth weight, as a measure of intrauterine growth, is commonly used in epidemiological studies and is reported to be associated with adult lung function. However, findings regarding this association in previous studies have been inconsistent. Furthermore, no studies have reported associations stratified by age or smoking status, or adjusted for eosinophil count or other parameters related to type 2 airway inflammation. METHODS This cross-sectional study included 2632 men and 7237 women aged ≥20 years living in Miyagi Prefecture, Japan. Lung function was assessed based on spirometry. Birth weight data were obtained through a questionnaire survey. Analysis of covariance was used to evaluate the associations between birth weight and lung function, adjusting for potential confounders. Stratified analyses by age and smoking status were also conducted, together with a sub-analysis for low birth-weight participants. RESULTS Birth weight was positively associated with forced expiratory volume in 1 s (FEV1) for both sexes and with vital capacity in women, after adjusting for height, age, smoking status, and parameters related to type 2 airway inflammation. The stratified analysis for smoking status revealed associations in never-smokers and ex-smokers. When stratified by age, the associations were confirmed in middle-aged participants. The effect of smoking status on the FEV1 of low birth-weight participants was not significant. CONCLUSIONS Our analysis of a large, Japanese adult population showed that birth weight was independently and positively associated with adult lung function, even after adjustment for age, height, smoking status, and parameters related to type 2 airway inflammation.
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Affiliation(s)
- Takashi Ohe
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Mitsuhiro Yamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan.
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan.
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Tomohiro Nakamura
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Naho Tsuchiya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Akira Narita
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Mana Kogure
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Nobuo Fuse
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Shinichi Kuriyama
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan
| | - Ayumi Mitsune
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Ayumi Suzuki
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Shuichiro Matsumoto
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Tetsuya Hatakeyama
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Chikashi Iwasaki
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Manami Suzuki
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Naoya Fujino
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Tadahisa Numakura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Tomohiro Ichikawa
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Akira Koarai
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Tsutomu Tamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
| | - Masayuki Yamamoto
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808573, Japan; Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808575, Japan
| | - Masakazu Ichinose
- Osaki Citizen Hospital Academic Center, 3-8-1 Furukawahonami, Osaki, Miyagi 9896136, Japan
| | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 9808574, Japan
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14
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Goldfarb DG, Hall CB, Choi J, Zeig-Owens R, Cohen HW, Cannon M, Prezant DJ, Weiden MD. Association of Lung Function Decline with All-Cause and Cancer-Cause Mortality after World Trade Center Dust Exposure. Ann Am Thorac Soc 2023; 20:1136-1143. [PMID: 36961515 PMCID: PMC10405606 DOI: 10.1513/annalsats.202212-1011oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/24/2023] [Indexed: 03/25/2023] Open
Abstract
Rationale: In numerous cohorts, lung function decline is associated with all-cause and cardiovascular-cause mortality, but the association between the decrease in forced expiratory volume in 1 second (FEV1) and cancer-cause mortality, particularly after occupational/environmental exposure(s), is unclear. Exposure to dust/smoke from the World Trade Center (WTC) disaster caused inflammation and lung injury in Fire Department of the City of New York rescue/recovery workers. In addition, prior research found that >10% of the cohort experienced greater than twice the age-related decrease in FEV1 (⩾64 ml/yr). Objectives: To evaluate the association of longitudinal lung function with all-cause and cancer-cause mortality after exposure to the WTC disaster. Methods: We conducted a prospective cohort study using longitudinal prebronchodilator FEV1 data for 12,264 WTC-exposed firefighters and emergency medical service providers. All-cause and cancer-cause mortality were ascertained using National Death Index data from September 12, 2001, through December 31, 2021. Joint longitudinal survival models evaluated the association of baseline FEV1 and change in FEV1 from baseline with all-cause and cancer-cause mortality adjusted for age, race/ethnicity, height, smoking, work assignment (firefighters vs. emergency medical service providers), and WTC exposure. Results: By December 31, 2021, 607 of the 12,264 individuals in the cohort (4.9%) had died (crude rate = 259.5 per 100,000 person-years), and 190 of 12,264 (1.5%) had died from cancer (crude rate = 81.2 per 100,000 person-years). Baseline FEV1 was ⩾80% predicted in 10,970 of the 12,264 (89.4%); final FEV1 was ⩾80% in 9,996 (81.5%). Lower FEV1 at baseline was associated with greater risk for all-cause mortality (hazard ratio [HR] per liter = 2.32; 95% confidence interval [95% CI] = 1.98-2.72) and cancer-cause mortality (HR per liter = 1.99; 95% CI = 1.49-2.66). Longitudinally, each 100-ml/yr decrease in FEV1 was associated with an 11% increase in all-cause mortality (HR = 1.11; 95% CI = 1.06-1.15) and a 7% increase in cancer-cause mortality (HR = 1.07; 95% CI = 1.00-1.15). Compared with FEV1 decrease <64 ml/yr, those with FEV1 decrease ⩾64 ml/yr had higher all-cause (HR = 2.91; 95% CI = 2.37-3.56) and cancer-cause mortality (HR = 2.68; 95% CI = 1.90-3.79). Conclusions: Baseline FEV1 and longitudinal FEV1 decrease are associated with increased risk of all-cause and cancer-cause mortality in a previously healthy occupational cohort, the majority of whom had normal lung function, after intense exposure to dust/smoke. Further investigation is needed to define pathways by which lung function impacts mortality after an irritant exposure.
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Affiliation(s)
- David G. Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
| | - Charles B. Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Jaeun Choi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Hillel W. Cohen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Madeline Cannon
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
| | - David J. Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, New York
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; and
| | - Michael D. Weiden
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York
- Department of Medicine, New York University Grossman School of Medicine, New York, New York
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15
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Takase M, Yamada M, Nakamura T, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Kanno I, Nochioka K, Tsuchiya N, Hirata T, Hamanaka Y, Sugawara J, Kobayashi T, Fuse N, Uruno A, Kodama EN, Kuriyama S, Tsuji I, Hozawa A. The Association of Lung Function and Carotid Intima-Media Thickness in a Japanese Population: The Tohoku Medical Megabank Community-Based Cohort Study. J Atheroscler Thromb 2023; 30:1022-1044. [PMID: 36328568 PMCID: PMC10406635 DOI: 10.5551/jat.63826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/21/2022] [Indexed: 08/04/2023] Open
Abstract
AIM Impaired lung function is associated with atherosclerotic vascular events. Carotid intima-media thickness (cIMT) is a marker for subclinical atherosclerosis. However, few studies have examined the association between lung function and cIMT among never smokers or individuals stratified by age. We investigated the association between lung function and cIMT in the Japanese population. METHODS We conducted a cross-sectional study of 3,716 men and 8,765 women aged 20 years or older living in Miyagi Prefecture, Japan. Lung function was evaluated using forced expiratory volume at 1 s (FEV1) and forced vital capacity (FVC) was measured using spirometry. The maximum common carotid artery was measured using high-resolution B-mode ultrasound. An analysis of covariance was used to assess associations between lung function and cIMT and adjusted for potential confounders. A linear trend test was conducted by scoring the categories from 1 (lowest) to 4 (highest) and entering the score as a continuous term in the regression model. RESULTS After adjusting for potential confounders including passive smoking, lower FEV1 and FVC were associated with higher cIMT in both men and women (P<0.001 for linear trend). This association was confirmed even when we restricted our study to never smokers. Furthermore, even when we stratified by age, an inverse association between lung function and cIMT was confirmed in middle-aged (40-64 years) and elderly participants (65-74 years). CONCLUSIONS Lower lung function was associated with higher cIMT in the Japanese population independent of age and smoking. Assessment of atherosclerosis or lung function may be required for individuals with lower lung function or atherosclerosis.
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Affiliation(s)
- Masato Takase
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | | | - Tomohiro Nakamura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Institute for Clinical and Translational Science, Nara Medical University, Nara, Japan
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Hospital, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Ichiro Tsuji
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
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16
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Lim HS, Kim DK, Gil HI, Lee MY, Lee HS, Lee YT, Yoon KJ, Park CH. Association of Pulmonary Function with Osteosarcopenic Obesity in Older Adults Aged over 50 Years. Nutrients 2023; 15:2933. [PMID: 37447259 DOI: 10.3390/nu15132933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Osteosarcopenic obesity (OSO) is a newly described coexistence of osteopenia/osteoporosis, sarcopenia, and obesity. We examined the association between pulmonary function, OSO, and its composition in adults aged ≥ 50 years. A total of 26,343 participants (8640 men; 17,703 women) were classified into four groups based on the number of abnormal body compositions (osteopenia/osteoporosis, sarcopenia, and obesity): 0 (control), 1+, 2+, and 3+ (OSO) abnormal body compositions. The values of forced volume vital capacity (FVC)%, forced expiratory volume in 1 s (FEV1%), and FEV1/FVC% were significantly decreased by increasing the number of adverse body compositions (p < 0.0001). Although the prevalence of restrictive spirometry pattern (RSP) was positively associated with a higher number of abnormal body composition parameters (p < 0.001), obstructive spirometry pattern (OSP) had no association with adverse body composition. In multivariate analyses, the adjusted odds ratios (ORs) for RSP compared to the control group were 1.36 in 1+, 1.47 in 2+, and 1.64 in 3+ abnormal body compositions (p for trend < 0.001). Multiple abnormal body composition, especially osteosarcopenic obesity, was independently associated with poor lung function showing RSP in older adults over 50 years. The coexistence of these abnormal body compositions may be a predisposing factor for pulmonary function deterioration.
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Affiliation(s)
- Han-Sol Lim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Dong-Kun Kim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Hyun-Il Gil
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Hyun-Seung Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
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17
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Mpotje T, More J, Rajkumar-Bhugeloo K, Moodley D, Marakalala MJ. Validation of proteins associated with pathological damage in human tuberculosis granulomas: study protocol. Wellcome Open Res 2023; 8:139. [PMID: 37090480 PMCID: PMC10113799 DOI: 10.12688/wellcomeopenres.19226.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
The presence of the Tuberculosis (TB) disease-causing pathogen, Mycobacterium Tuberculosis (Mtb), induces the development of a pathological feature termed granuloma, which the host uses to contain the bacteria. However, the granuloma may dissociate resulting in detrimental caseation of the lung. The disease contributes to a growing global burden of lung function challenges, warranting for more understanding of the TB-induced immunopathology. The current study aims to explore in detail host factors that drive pathological features of TB contributing to extensive lung tissue destruction. Lung tissue sections obtained from patients undergoing surgical resection will be processed and analyzed using histopathological assays including Immunohistochemistry, Immunofluorescence, Hematoxylin and Eosin staining and Laser Capture Microdissection. The findings will provide key host factors that associate with exacerbated lung immunopathology during TB.
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Affiliation(s)
- Thabo Mpotje
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
- Basic and Translational Science, Africa Health Research Institute, Durban, KwaZulu-Natal, 4001, South Africa
| | - Jessica More
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
- Basic and Translational Science, Africa Health Research Institute, Durban, KwaZulu-Natal, 4001, South Africa
| | - Kerishka Rajkumar-Bhugeloo
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
- Basic and Translational Science, Africa Health Research Institute, Durban, KwaZulu-Natal, 4001, South Africa
| | - Denelle Moodley
- Basic and Translational Science, Africa Health Research Institute, Durban, KwaZulu-Natal, 4001, South Africa
| | - Mohlopheni J Marakalala
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 4001, South Africa
- Basic and Translational Science, Africa Health Research Institute, Durban, KwaZulu-Natal, 4001, South Africa
- Division of Infection and Immunity, University College London, London, England, UK
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18
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Zhang M, Zhang M, Zeng Q, Lin D, Zhang N. Association of p-phenylenediamine exposure with alterations of pulmonary function, pruritus and health-related quality of life in hair dye factory workers: a cross-sectional study. Sci Rep 2023; 13:2623. [PMID: 36788348 PMCID: PMC9929233 DOI: 10.1038/s41598-023-29721-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
P-Phenylenediamine (PPD) is a common component of hair dye, which can cause skin contact allergy and asthma with impaired pulmonary function. However, the adverse effects of occupational exposure to different dose PPD was rarely mentioned. We recruited 124 workers from a hair dye factory to explore the association of occupational PPD exposure on pulmonary function, pruritus and health related quality of life (HRQL). We categorized exposure to PPD into 3 levels: lower exposure group (< 0.00001 mg/m3); middle exposure group (0.00001-0.00033 mg/m3); higher exposure group (0.00033-0.047 mg/m3). The HRQL and subjective pruritus of the workers were assessed by the short form 36 health survey (SF-36) and Visual analogue scale (VAS) of pruritus, respectively. In the high PPD-exposed group, the percentage of FEV1 (FEV1%) was lower in higher exposure group compared with lower exposure group. The FEV1/FVC was also lower in comparison to the higher exposure and middle exposure groups (p < 0.05). PPD levels were negatively correlated with vitality and mental health (p < 0.01). The structural equation model showed the positive effects of PPD on VAS level (β = 0.213, p < 0.001), and indicated partly negtive effects of PPD on total score of SF-36 (β = - 0.465, p = 0.002), respectively. Our results indicate that occupational exposure to PPD might be associated with pulmonary function impairment, poor HRQL, and subjective pruritus of the workers.
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Affiliation(s)
- Ming Zhang
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, People's Republic of China.
| | - Meibian Zhang
- grid.198530.60000 0000 8803 2373National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, 100050 People’s Republic of China
| | - Qiang Zeng
- grid.464467.3Tianjin Centers for Disease Control and Prevention, Tianjin, 300011 People’s Republic of China
| | - Dafeng Lin
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020 People’s Republic of China
| | - Naixing Zhang
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, 518020, People's Republic of China.
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19
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Strassmann A, Çolak Y, Serra-Burriel M, Nordestgaard BG, Turk A, Afzal S, Puhan MA. Nationwide indoor smoking ban and impact on smoking behaviour and lung function: a two-population natural experiment. Thorax 2023; 78:144-150. [PMID: 35277448 PMCID: PMC9872239 DOI: 10.1136/thoraxjnl-2021-218436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/10/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Many countries have implemented indoor smoking bans over the past two decades. Although smoking bans have been shown to reduce cardiovascular outcomes, little is known about their impact on respiratory health. This study investigated the impact of a nationwide indoor smoking ban on smoking behaviour and lung function. METHODS We used repeated cross-sectional data from two large cohorts of the general population comprising 31 807 Swiss and 62 093 Danish adults. We compared associations between smoking ban and smoking prevalence and prebronchodilator lung function trends in Denmark (indoor smoking ban introduced in 2007) and Switzerland (indoor smoking ban introduced in 2010) from 2005 to 2010 using a quasi-experimental study design. We performed difference-in-difference analyses with linear regression models adjusted for age, sex, weight and height. RESULTS Denmark had a stronger decrease in active smokers compared with Switzerland. Also, forced expiratory volume in the first second was higher in Danish adults than in Swiss adults: 26 mL (95% CI 2.4 to 49) 1 year, 88 mL (65 to 112) 2 years, and 74 mL (51 to 98) 3 years after smoking ban implementation. Correspondingly, forced vital capacity was higher in Danish adults compared with Swiss adults (80 mL (50 to 109) after 1 year and 126 mL (97 to 155) after two and 3 years). Improvements were observed in both never-smokers and ever-smokers, most pronounced in ever-smokers. CONCLUSIONS Nationwide indoor smoking ban is associated with less smoking and improved lung function in the general population. Implementing an indoor smoking ban can improve lung function by influencing smoking behaviour and reducing secondhand smoke.
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Affiliation(s)
- Alexandra Strassmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Yunus Çolak
- Department of Respiratory Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Miquel Serra-Burriel
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Børge G Nordestgaard
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | | | - Shoaib Afzal
- The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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20
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Zhang Y, Cheng C, Wei F, Wu Z, Cui H, Liu L, Lu F, Peng J, Yang J. Reduced peak expiratory flow predicts increased risk of cardiovascular disease: A 10-year prospective cohort study in Eastern China. Respir Med Res 2023; 83:100988. [PMID: 36634554 DOI: 10.1016/j.resmer.2022.100988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 12/10/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The correlation between impaired lung function and cardiovascular diseases (CVD) has attracted more and more attention. We aimed to assess the longitudinal association between decreased peak expiratory flow (PEF) and cardiovascular risk among Eastern Chinese general population. METHODS In total, 6295 participants aged>30 years and free of CVD at baseline were followed for up to 10 years in Eastern China. The adjusted hazard ratios (HRs) for CVD and mortality associated with decreased PEF were analyzed. RESULTS Among all participants, 421 CVD incident events were reported during 10-year follow-up, and a total of 272 participants died during the follow-up period, 94 of them from CVD. The HRs in the lowest group of PEF (PEF ≤218.33 L/min) were 1.31 (95% confidence interval [CI]:1.01 to 1.68) for high CVD incidence (172 vs 116), 2.43 (95% CI:1.72 to 3.42) for all-cause mortality (156 vs 48), and 3.94 (95% CI:1.96 to 7.92) for CVD mortality (59 vs 10) when compared with the highest group (PEF ≥321.68 L/min). CONCLUSION The decreased PEF was associated with increased CVD incidence, CVD and all-cause mortality in Eastern Chinese general population.
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Affiliation(s)
- Yerui Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Cheng Cheng
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China; Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, 110004, China
| | - Fang Wei
- Jinan Central hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhenguo Wu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Huiliang Cui
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Li Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Shandong Academy of Medical Sciences, Jinan, China
| | - Jie Peng
- Department of Geriatric Medicine, Qilu Hospital of Shandong University, Key Laboratory of Cardiovascular Proteomics of Shandong Province, Jinan, China.
| | - Jianmin Yang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China.
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21
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Dapas M, Thompson EE, Wentworth-Sheilds W, Clay S, Visness CM, Calatroni A, Sordillo JE, Gold DR, Wood RA, Makhija M, Khurana Hershey GK, Sherenian MG, Gruchalla RS, Gill MA, Liu AH, Kim H, Kattan M, Bacharier LB, Rastogi D, Altman MC, Busse WW, Becker PM, Nicolae D, O’Connor GT, Gern JE, Jackson DJ, Ober C. Multi-omic association study identifies DNA methylation-mediated genotype and smoking exposure effects on lung function in children living in urban settings. PLoS Genet 2023; 19:e1010594. [PMID: 36638096 PMCID: PMC9879483 DOI: 10.1371/journal.pgen.1010594] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 01/26/2023] [Accepted: 12/23/2022] [Indexed: 01/14/2023] Open
Abstract
Impaired lung function in early life is associated with the subsequent development of chronic respiratory disease. Most genetic associations with lung function have been identified in adults of European descent and therefore may not represent those most relevant to pediatric populations and populations of different ancestries. In this study, we performed genome-wide association analyses of lung function in a multiethnic cohort of children (n = 1,035) living in low-income urban neighborhoods. We identified one novel locus at the TDRD9 gene in chromosome 14q32.33 associated with percent predicted forced expiratory volume in one second (FEV1) (p = 2.4x10-9; βz = -0.31, 95% CI = -0.41- -0.21). Mendelian randomization and mediation analyses revealed that this genetic effect on FEV1 was partially mediated by DNA methylation levels at this locus in airway epithelial cells, which were also associated with environmental tobacco smoke exposure (p = 0.015). Promoter-enhancer interactions in airway epithelial cells revealed chromatin interaction loops between FEV1-associated variants in TDRD9 and the promoter region of the PPP1R13B gene, a stimulator of p53-mediated apoptosis. Expression of PPP1R13B in airway epithelial cells was significantly associated the FEV1 risk alleles (p = 1.3x10-5; β = 0.12, 95% CI = 0.06-0.17). These combined results highlight a potential novel mechanism for reduced lung function in urban youth resulting from both genetics and smoking exposure.
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Affiliation(s)
- Matthew Dapas
- Department of Human Genetics, University of Chicago, Chicago Illinois, United States of America
| | - Emma E. Thompson
- Department of Human Genetics, University of Chicago, Chicago Illinois, United States of America
| | | | - Selene Clay
- Department of Human Genetics, University of Chicago, Chicago Illinois, United States of America
| | | | | | - Joanne E. Sordillo
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Robert A. Wood
- Department of Pediatrics, Johns Hopkins University Medical Center, Baltimore, Maryland, United States of America
| | - Melanie Makhija
- Division of Allergy and Immunology, Ann & Robert H. Lurie Children’s Hospital, Chicago, Illinois, United States of America
| | - Gurjit K. Khurana Hershey
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Michael G. Sherenian
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Rebecca S. Gruchalla
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Michelle A. Gill
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Andrew H. Liu
- Department of Allergy and Immunology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Haejin Kim
- Department of Medicine, Henry Ford Health System, Detroit, Michigan, United States of America
| | - Meyer Kattan
- Columbia University College of Physicians and Surgeons, New York, New York, United States of America
| | - Leonard B. Bacharier
- Monroe Carell Jr. Children’s Hospital at Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Deepa Rastogi
- Children’s National Health System, Washington, District of Columbia, United States of America
| | - Matthew C. Altman
- Department of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, United States of America
| | - William W. Busse
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Patrice M. Becker
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Dan Nicolae
- Department of Statistics, University of Chicago, Chicago, Illinois, United States of America
| | - George T. O’Connor
- Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - James E. Gern
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Daniel J. Jackson
- Department of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - Carole Ober
- Department of Human Genetics, University of Chicago, Chicago Illinois, United States of America
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22
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Muacevic A, Adler JR, Mahathevan K. Pulmonary Function Tests as a Biomarker in Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia Patients Treated With Somatostatin Analogues. Cureus 2022; 14:e32454. [PMID: 36644074 PMCID: PMC9834669 DOI: 10.7759/cureus.32454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/14/2022] Open
Abstract
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) describes an indolent, under-recognised and poorly understood pulmonary condition with fewer than 200 reported cases across the literature. Currently, cases are diagnosed following a biopsy of the primary lesion, with treatment options centring on symptomatic benefit as opposed to targeting the underlying aetiology. Classically, DIPNECH lesions have been described as slow growing and benign, but with growing awareness of the condition, reports of metastatic disease with significant symptomatic burden have been reported. However, effectively addressing the subset of DIPNECH patients with greater metastatic potential remains an unmet clinical need. Due to the similarities between DIPNECH and carcinoid patients, several centres have considered using somatostatin analogues to not only help symptomatically but also to initiate tumour regression. However, to date, there are limited biomarkers to help evaluate the benefit of such options. In this review, we consider the use of pulmonary function tests (PFTs) to help quantify the benefit of somatostatin analogues. Although much of the evidence stems from small single-centre studies, the use of PFTs within the treatment pathway for both localised and metastatic DIPNECH represents a meaningful improvement from subjective monitoring of disease.
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Huang N, Tang C, Li S, Ma W, Zhai X, Liu K, Sheerah HA, Cao J. Association of lung function with the risk of cardiovascular diseases and all-cause mortality in patients with diabetes: Results from NHANES III 1988-1994. Front Cardiovasc Med 2022; 9:976817. [PMID: 36158788 PMCID: PMC9500166 DOI: 10.3389/fcvm.2022.976817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe potential effects of pulmonary dysfunction on cardiovascular diseases (CVD) and all-cause mortality are receiving attention. The current study aimed to explore whether reduced lung function predicts CVD and all-cause mortality in people with diabetes.MethodsA total of 1,723 adults with diabetes (mean age 60.2 years) were included in the National Health and Nutrition Examination Survey (NHANES III). Death outcomes were ascertained by linkage to the database records through 31 December 2015. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for coronary heart disease (CHD), CVD, and all-cause mortalities. We conducted stratified analyses based on age, body mass index (BMI), history of hypertension, and dyslipidemia.ResultsDuring a mean follow-up of 14.62 years (25,184 person-year), a total of 1,221 deaths were documented, of which 327 were CHD, 406 were CVD, and 197 were cancer. After multi-factor adjustment, participants with lower FEV1 and FVC had a higher risk of CHD, CVD, and all-cause mortality. This association was also found in lower FVC and a higher risk of cancer mortality [HR: 3.85 (1.31–11.32); P for trend = 0.040], but the association of FEV1 was attenuated after adjustment for covariates [HR:2.23 (0.54–9.17); P for trend = 0.247]. In subgroup analysis, we found that the adverse associations of FEV1 and FVC with CVD mortality were observed in subgroups of age, BMI, and history of hypertension and dyslipidemia.ConclusionDeclined lung function was associated with a higher risk of CVD and all-cause mortality in people with diabetes. Lung function tests, especially FEV1 and FVC, should be encouraged to provide prognostic and predictive information for the management of CVD and all-cause mortality in patients with diabetes.
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Affiliation(s)
- Nian Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Chengyao Tang
- Division of Biomedical Statistics, Department of Integrated Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Shiyang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Wenzhi Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xiaobing Zhai
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Haytham A. Sheerah
- Health Promotion and Health Education Research Chair, King Saud University, Riyadh, Saudi Arabia
- Ministry of Health, International Health Regulations, Riyadh, Saudi Arabia
| | - Jinhong Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
- *Correspondence: Jinhong Cao
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24
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Lee M, Huan T, McCartney DL, Chittoor G, de Vries M, Lahousse L, Nguyen JN, Brody JA, Castillo-Fernandez J, Terzikhan N, Qi C, Joehanes R, Min JL, Smilnak GJ, Shaw JR, Yang CX, Colicino E, Hoang TT, Bermingham ML, Xu H, Justice AE, Xu CJ, Rich SS, Cox SR, Vonk JM, Prokić I, Sotoodehnia N, Tsai PC, Schwartz JD, Leung JM, Sikdar S, Walker RM, Harris SE, van der Plaat DA, Van Den Berg DJ, Bartz TM, Spector TD, Vokonas PS, Marioni RE, Taylor AM, Liu Y, Barr RG, Lange LA, Baccarelli AA, Obeidat M, Fornage M, Wang T, Ward JM, Motsinger-Reif AA, Hemani G, Koppelman GH, Bell JT, Gharib SA, Brusselle G, Boezen HM, North KE, Levy D, Evans KL, Dupuis J, Breeze CE, Manichaikul A, London SJ. Pulmonary Function and Blood DNA Methylation: A Multiancestry Epigenome-Wide Association Meta-analysis. Am J Respir Crit Care Med 2022; 206:321-336. [PMID: 35536696 PMCID: PMC9890261 DOI: 10.1164/rccm.202108-1907oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Rationale: Methylation integrates factors present at birth and modifiable across the lifespan that can influence pulmonary function. Studies are limited in scope and replication. Objectives: To conduct large-scale epigenome-wide meta-analyses of blood DNA methylation and pulmonary function. Methods: Twelve cohorts analyzed associations of methylation at cytosine-phosphate-guanine probes (CpGs), using Illumina 450K or EPIC/850K arrays, with FEV1, FVC, and FEV1/FVC. We performed multiancestry epigenome-wide meta-analyses (total of 17,503 individuals; 14,761 European, 2,549 African, and 193 Hispanic/Latino ancestries) and interpreted results using integrative epigenomics. Measurements and Main Results: We identified 1,267 CpGs (1,042 genes) differentially methylated (false discovery rate, <0.025) in relation to FEV1, FVC, or FEV1/FVC, including 1,240 novel and 73 also related to chronic obstructive pulmonary disease (1,787 cases). We found 294 CpGs unique to European or African ancestry and 395 CpGs unique to never or ever smokers. The majority of significant CpGs correlated with nearby gene expression in blood. Findings were enriched in key regulatory elements for gene function, including accessible chromatin elements, in both blood and lung. Sixty-nine implicated genes are targets of investigational or approved drugs. One example novel gene highlighted by integrative epigenomic and druggable target analysis is TNFRSF4. Mendelian randomization and colocalization analyses suggest that epigenome-wide association study signals capture causal regulatory genomic loci. Conclusions: We identified numerous novel loci differentially methylated in relation to pulmonary function; few were detected in large genome-wide association studies. Integrative analyses highlight functional relevance and potential therapeutic targets. This comprehensive discovery of potentially modifiable, novel lung function loci expands knowledge gained from genetic studies, providing insights into lung pathogenesis.
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Affiliation(s)
| | - Tianxiao Huan
- Department of Ophthalmology, University of Massachusetts Medical School, Worcester, Massachusetts.,Framingham Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, Framingham, Massachusetts
| | - Daniel L McCartney
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer and
| | - Geetha Chittoor
- Department of Population Health Sciences, Geisinger, Danville, Pennsylvania.,Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Maaike de Vries
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD, and
| | - Lies Lahousse
- Department of Bioanalysis, Ghent University, Ghent, Belgium.,Department of Epidemiology and
| | - Jennifer N Nguyen
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Division of Cardiology, Department of Medicine
| | - Juan Castillo-Fernandez
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | | | - Cancan Qi
- Groningen Research Institute for Asthma and COPD, and.,Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Roby Joehanes
- Framingham Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, Framingham, Massachusetts
| | - Josine L Min
- Medical Research Council Integrative Epidemiology Unit and.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Jessica R Shaw
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, and
| | - Chen Xi Yang
- Centre for Heart Lung Innovation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Mairead L Bermingham
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer and
| | - Hanfei Xu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Anne E Justice
- Department of Population Health Sciences, Geisinger, Danville, Pennsylvania.,Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Cheng-Jian Xu
- Centre for Individualised Infection Medicine, a joint venture between Hannover Medical School and the Helmholtz Centre for Infection Research, Hannover, Germany.,Research Group Bioinformatics and Computational Genomics, TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture between the Helmholtz Centre for Infection Research and the Hannover Medical School, Hannover, Germany.,Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.,Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Stephen S Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | - Simon R Cox
- Lothian Birth Cohorts Group, Department of Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Judith M Vonk
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD, and
| | | | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, Department of Epidemiology
| | - Pei-Chien Tsai
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.,Department of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan.,Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Joel D Schwartz
- Department of Environmental Health and.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.,Channing Laboratory, Harvard Medical School, Boston, Massachusetts
| | - Janice M Leung
- Centre for Heart Lung Innovation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sinjini Sikdar
- Epidemiology Branch.,Department of Mathematics and Statistics, Old Dominion University, Norfolk, Virginia
| | - Rosie M Walker
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer and
| | - Sarah E Harris
- Lothian Birth Cohorts Group, Department of Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Diana A van der Plaat
- Department of Epidemiology.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - David J Van Den Berg
- Department of Preventive Medicine and.,Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Biostatistics
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Pantel S Vokonas
- Veterans Affairs Boston Healthcare System, School of Medicine and School of Public Health, Boston University, Boston, Massachusetts
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer and
| | - Adele M Taylor
- Lothian Birth Cohorts Group, Department of Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Yongmei Liu
- Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina
| | - R Graham Barr
- Department of Medicine and.,Department of Epidemiology, Columbia University Medical Center, New York, New York
| | - Leslie A Lange
- Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, and.,Department of Epidemiology, University of Colorado, Aurora, Colorado
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Ma'en Obeidat
- Centre for Heart Lung Innovation, The University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, and.,Human Genetics Center, School of Public Health, University of Texas Health Science Center, Houston, Texas
| | | | | | - Alison A Motsinger-Reif
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Gibran Hemani
- Medical Research Council Integrative Epidemiology Unit and.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Gerard H Koppelman
- Groningen Research Institute for Asthma and COPD, and.,Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jordana T Bell
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Sina A Gharib
- Cardiovascular Health Research Unit, Division of Cardiology, Department of Medicine.,Computational Medicine Core, Center for Lung Biology, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington
| | - Guy Brusselle
- Department of Epidemiology and.,Department of Respiratory Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; and
| | - H Marike Boezen
- Department of Epidemiology.,Groningen Research Institute for Asthma and COPD, and
| | - Kari E North
- Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Daniel Levy
- Framingham Heart Study, National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, Framingham, Massachusetts
| | - Kathryn L Evans
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer and
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | | | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
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25
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di Filippo L, Compagnone N, Frara S, Allora A, Doga M, Rovere Querini P, Cremona G, Giustina A. Vertebral fractures at hospitalization predict impaired respiratory function during follow-up of COVID-19 survivors. Endocrine 2022; 77:392-400. [PMID: 35676466 DOI: 10.1007/s12020-022-03096-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/24/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Morphometric vertebral fractures (VFs) have been recently reported as an important component of the endocrine phenotype of COVID-19 and emerging data show negative respiratory sequelae at long-term follow-up in COVID-19 survivors. The aim of this study was to evaluate the impact of VFs on respiratory function in COVID-19 survivors. METHODS We included patients referred to our Hospital Emergency Department and re-evaluated during follow-up. VFs were detected on lateral chest X-rays on admission using a qualitative and semiquantitative assessment and pulmonary function tests were obtained by Jaeger-MasterScreen-Analyzer Unit 6 months after discharge. RESULTS Fifty patients were included. Median age was 66 years and 66% were males. No respiratory function data were available at COVID-19 diagnosis. VFs were detected in 16 (32%) patients. No differences between fractured and non-fractured patients regarding age and sex were observed. Although no difference was observed between VF and non-VF patient groups in the severity of pneumonia as assessed by Radiological-Assessment-of-Lung-Edema score at admission, (5 vs. 6, p = 0.69), patients with VFs were characterized as compared to those without VFs by lower Forced Vital Capacity (FVC, 2.9 vs. 3.6 L, p = 0.006; 85% vs. 110% of predicted, respectively, p = 0.001), Forced Expiratory Volume 1st s (FEV1, 2.2 vs. 2.8 L, p = 0.005; 92% vs. 110% of predicted, respectively, p = 0.001) and Diffusing Capacity of the Lungs for Carbon Monoxide (DLCO 5.83 vs. 6.98 mmol/min/kPa, p = 0.036, 59% vs. 86.3% of predicted, respectively, p = 0.043) at 6-month follow up. CONCLUSIONS VFs, expression of the endocrine phenotype of the disease, appear to influence medium-term impaired respiratory function of COVID-19 survivors which may significantly influence their recovery. Therefore, our findings suggest that a VFs assessment at baseline may help in identifying patients needing a more intensive respiratory follow-up and patients showing persistent respiratory impairment without evidence of pulmonary disease may benefit from VFs assessment to preventing the vicious circle of further fractures and respiratory deterioration.
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Affiliation(s)
- Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Nicola Compagnone
- Division of Transplantation, Immunology and Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Agnese Allora
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Mauro Doga
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Patrizia Rovere Querini
- Division of Transplantation, Immunology and Infectious Diseases, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - George Cremona
- Unit of Respiratory Medicine, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy.
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26
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Park SS, Perez Perez JL, Perez Gandara B, Agudelo CW, Rodriguez Ortega R, Ahmed H, Garcia-Arcos I, McCarthy C, Geraghty P. Mechanisms Linking COPD to Type 1 and 2 Diabetes Mellitus: Is There a Relationship between Diabetes and COPD? Medicina (B Aires) 2022; 58:medicina58081030. [PMID: 36013497 PMCID: PMC9415273 DOI: 10.3390/medicina58081030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/09/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) patients frequently suffer from multiple comorbidities, resulting in poor outcomes for these patients. Diabetes is observed at a higher frequency in COPD patients than in the general population. Both type 1 and 2 diabetes mellitus are associated with pulmonary complications, and similar therapeutic strategies are proposed to treat these conditions. Epidemiological studies and disease models have increased our knowledge of these clinical associations. Several recent genome-wide association studies have identified positive genetic correlations between lung function and obesity, possibly due to alterations in genes linked to cell proliferation; embryo, skeletal, and tissue development; and regulation of gene expression. These studies suggest that genetic predisposition, in addition to weight gain, can influence lung function. Cigarette smoke exposure can also influence the differential methylation of CpG sites in genes linked to diabetes and COPD, and smoke-related single nucleotide polymorphisms are associated with resting heart rate and coronary artery disease. Despite the vast literature on clinical disease association, little direct mechanistic evidence is currently available demonstrating that either disease influences the progression of the other, but common pharmacological approaches could slow the progression of these diseases. Here, we review the clinical and scientific literature to discuss whether mechanisms beyond preexisting conditions, lifestyle, and weight gain contribute to the development of COPD associated with diabetes. Specifically, we outline environmental and genetic confounders linked with these diseases.
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Affiliation(s)
- Sangmi S. Park
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Jessica L. Perez Perez
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Brais Perez Gandara
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Christina W. Agudelo
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Romy Rodriguez Ortega
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Huma Ahmed
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Itsaso Garcia-Arcos
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
| | - Cormac McCarthy
- University College Dublin School of Medicine, Education and Research Centre, St. Vincent’s University Hospital, D04 T6F4 Dublin, Ireland;
| | - Patrick Geraghty
- Department of Medicine, State University of New York Downstate Health Sciences University, Brooklyn, NY 11203, USA; (S.S.P.); (J.L.P.P.); (B.P.G.); (C.W.A.); (R.R.O.); (H.A.); (I.G.-A.)
- Correspondence: ; Tel.: +1-718-270-3141
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27
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Sarycheva T, Capkova N, Pająk A, Malyutina S, Tamosiunas A, Bobák M, Pikhart H. All-cause and cardiovascular mortality in relation to lung function in the full range of distribution across four Eastern European cohorts. Sci Rep 2022; 12:12959. [PMID: 35902678 DOI: 10.1038/s41598-022-17261-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/22/2022] [Indexed: 11/08/2022] Open
Abstract
It is unclear whether the dose–response relationship between lung function and all-cause and cardiovascular mortality in the Central and Eastern European populations differ from that reported in the Western European and American populations. We used the prospective population-based HAPIEE cohort that includes randomly selected people with a mean age of 59 ± 7.3 years from population registers in Czech, Polish, Russian and Lithuanian urban centres. The baseline survey in 2002–2005 included 36,106 persons of whom 24,944 met the inclusion criteria. Cox proportional hazards models were used to estimate the dose–response relationship between lung function defined as FEV1 divided by height cubed and all-cause and cardiovascular mortality over 11–16 years of follow-up. Mortality rate increased in a dose–response manner from highest to lower FEV1/height3 deciles. Adjusted hazard ratios (HR) of all-cause mortality for persons in the 8th best, the 5th and the worst deciles were 1.27 (95% CI 1.08‒1.49), 1.37 (1.18–1.60) and 2.15 (1.86‒2.48), respectively; for cardiovascular mortality, the respective HRs were 1.84 (1.29–2.63), 2.35 (1.67–3.28) and 3.46 (2.50‒4.78). Patterns were similar across countries, with some statistically insignificant variation. FEV1/height3 is a strong predictor of all-cause and cardiovascular mortality, across full distribution of values, including persons with preserved lung function.
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28
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Feng X, Zeng G, Zhang Q, Song B, Wu KH. Joint association of polycyclic aromatic hydrocarbons and heavy metal exposure with pulmonary function in children and adolescents aged 6-19 years. Int J Hyg Environ Health 2022; 244:114007. [PMID: 35853342 DOI: 10.1016/j.ijheh.2022.114007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022]
Abstract
Studies have reported associations between polycyclic aromatic hydrocarbon (PAH) or heavy metal (HM) exposure and respiratory diseases. However, evidence of their joint associations with pulmonary function, especially in children and adolescents aged 6-19 years, is lacking. We utilized cross-sectional data from 1,734 children and adolescents aged 6-19 years collected in the National Health and Nutrition Examination Survey 2007-2012 and analysed mixed PAH and mixed HM exposures and their joint association with pulmonary function by applying weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR). Multivariate linear regressions were carried out to determine the relationships between individual urinary PAH metabolites or blood HM levels and pulmonary function indices. We found that mixed PAHs and HMs were negatively related to forced expiratory volume in 1 s (FEV1) in subjects aged 6-12 years (all p values < 0.05). We found synergistic associations of PAH and HM exposure on pulmonary function impairment, mainly in children; lead (Pb) was the most damaging. In the analysis of individual PAH metabolites or HMs, Pb exposure was negatively associated with FEV1 values in all subgroups (all p values < 0.05). Thus, our findings indicate that increased PAH or HM exposure is associated with impairments to pulmonary function and that this association is more pronounced in children.
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29
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Kuhn M, Kohlbrenner D, Sievi NA, Clarenbach CF. Increasing Daily Physical Activity and Its Effects on QTc Time in Severe to Very Severe COPD: A Secondary Analysis of a Randomised Controlled Trial. COPD 2022; 19:339-344. [PMID: 36166273 DOI: 10.1080/15412555.2022.2101992] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Approximately, half of COPD patients die from cardiovascular diseases. A prolongation of cardiac repolarization (measured as QTc interval) is associated with cardiovascular events or cardiovascular deaths in populations of older adults and COPD. One way to reduce the QTc could be to increase physical activity (PA). We investigated whether QTc can be reduced by an increase in PA in patients with severe COPD. This is a secondary outcome analysis from a randomized controlled trial investigating the effects of a 3 months pedometer based program to improve PA. 12-lead ECG was assessed at baseline and after 3 months. We measured PA using a validated triaxial accelerometer. Data were analyzed from 59 participants. Multiple regression modeling, including adjustment for baseline QTc, sex, QT prolonging medications, BMI, smoking status and FEV1%, showed no evidence for an association between an improvement of ≥15% PA and QTc reduction. A 15% improvement in PA according to step counts over 3 months seems not to reduce QTc interval by its MCID of 20 ms in patients with severe to very severe COPD.
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Affiliation(s)
- Manuel Kuhn
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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30
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Krick S, Geraghty P, Jourdan Le Saux C, Rojas M, Staab-Weijnitz CA. Editorial: Defining and Characterizing Respiratory Disease in an Aging Population. Front Med (Lausanne) 2022; 9:889834. [PMID: 35462999 PMCID: PMC9021609 DOI: 10.3389/fmed.2022.889834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/22/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Stefanie Krick
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- *Correspondence: Stefanie Krick
| | - Patrick Geraghty
- SUNY Downstate Health Sciences University, Brooklyn, NY, United States
| | - Claude Jourdan Le Saux
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Mauricio Rojas
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Claudia A. Staab-Weijnitz
- Institute of Lung Health and Immunity and Comprehensive Pneumology Center With the CPC-M BioArchive, Helmholtz Center München, Helmholtz Association of German Research Centres (HZ), Munich, Germany
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Martínez-Luna N, Orea-Tejeda A, González-Islas D, Flores-Cisneros L, Keirns-Davis C, Sánchez-Santillán R, Pérez-García I, Gastelum-Ayala Y, Martínez-Vázquez V, Martínez-Reyna Ó. Association between body composition, sarcopenia and pulmonary function in chronic obstructive pulmonary disease. BMC Pulm Med 2022; 22:106. [PMID: 35346135 PMCID: PMC8962175 DOI: 10.1186/s12890-022-01907-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/21/2022] [Indexed: 12/25/2022] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive and irreversible airflow limitation. Different factors that modify pulmonary function include age, sex, muscular strength, and a history of exposure to toxic agents. However, the impact of body composition compartments and sarcopenia on pulmonary function is not well-established. This study aimed to evaluate how body composition compartments and sarcopenia affect pulmonary function in COPD patients. Methods In a cross-sectional study, patients with a confirmed diagnosis of COPD, > 40 years old, and forced expiratory volume in the first second /forced vital capacity ratio (FEV1/FVC) < 0.70 post-bronchodilator were included. Patients with cancer, HIV, and asthma were excluded. Body composition was measured with bioelectrical impedance. Sarcopenia was defined according to EWGSOP2, and pulmonary function was assessed by spirometry. Results 185 patients were studied. The mean age was 72.20 ± 8.39 years; 55.14% were men. A linear regression adjusted model showed associations between body mass index, fat-free mass, skeletal muscle mass index, appendicular skeletal muscle mass index, and phase angle (PhA), and sarcopenia with FEV1 (%). As regards FVC (%), PhA and exercise tolerance had positive associations. Conclusion Body composition, especially PhA, SMMI, ASMMI, and sarcopenia, has a significant impact on pulmonary function. Early detection of disturbances of these indexes enables the early application of such therapeutic strategies in COPD patients.
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Affiliation(s)
- Nathalie Martínez-Luna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico.
| | - Laura Flores-Cisneros
- Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Candace Keirns-Davis
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Ilse Pérez-García
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Yael Gastelum-Ayala
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Valeria Martínez-Vázquez
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Óscar Martínez-Reyna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
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Duong M, Usman A, Ma J, Xie Y, Huang J, Zaman M, Dragoman A, Jiatong Chen S, Farooqi M, Raina P. Associations between lung function and physical and cognitive health in the Canadian Longitudinal Study on Aging (CLSA): A cross-sectional study from a multicenter national cohort. PLoS Med 2022; 19:e1003909. [PMID: 35139083 PMCID: PMC8870596 DOI: 10.1371/journal.pmed.1003909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 02/24/2022] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low lung function is associated with high mortality and adverse cardiopulmonary outcomes. Less is known of its association with broader health indices such as self-reported respiratory symptoms, perceived general health, and cognitive and physical performance. The present study seeks to address the association between forced expiratory volume in 1 second (FEV1), an indicator of lung function, with broad markers of general health, relevant to aging trajectory in the general population. METHODS AND FINDINGS From the Canadian general population, 22,822 adults (58% females, mean age 58.8 years [standard deviation (SD) 9.6]) were enrolled from the community between June 2012 and April 2015 from 11 Canadian cities and 7 provinces. Mixed effects regression was used to assess the cross-sectional relationship between FEV1 with self-reported respiratory symptoms, perceived poor general health, and cognitive and physical performance. All associations were adjusted for age, sex, body mass index (BMI), education, smoking status, and self-reported comorbidities and expressed as adjusted odds ratios (aORs). Based on the Global Lung Function Initiative (GLI) reference values, 38% (n = 8,626) had normal FEV1 (z-scores >0), 37% (n = 8,514) mild (z-score 0 to > -1 SD), 19% (n = 4,353) moderate (z-score -1 to > -2 SD), and 6% (n = 1,329) severely low FEV1 (z-score = < -2 SD). There was a graded association between lower FEV1 with higher aOR [95% CI] of self-reported moderate to severe respiratory symptoms (mild FEV1 1.09 [0.99 to 1.20] p = 0.08, moderate 1.45 [1.28 to 1.63] p < 0.001, and severe 2.67 [2.21 to 3.23] p < 0.001]), perceived poor health (mild 1.07 [0.9 to 1.27] p = 0.45, moderate 1.48 [1.24 to 1.78] p = <0.001, and severe 1.82 [1.42 to 2.33] p < 0.001]), and impaired cognitive performance (mild 1.03 [0.95 to 1.12] p = 0.41, moderate 1.16 [1.04 to 1.28] p < 0.001, and severe 1.40 [1.19 to 1.64] p < 0.001]). Similar graded association was observed between lower FEV1 with lower physical performance on gait speed, Timed Up and Go (TUG) test, standing balance, and handgrip strength. These associations were consistent across different strata by age, sex, tobacco smoking, obstructive, and nonobstructive impairment on spirometry. A limitation of the current study is the observational nature of these findings and that causality cannot be inferred. CONCLUSIONS We observed graded associations between lower FEV1 with higher odds of disabling respiratory symptoms, perceived poor general health, and lower cognitive and physical performance. These findings support the broader implications of measured lung function on general health and aging trajectory.
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Affiliation(s)
- MyLinh Duong
- Firestone Institute for Respiratory Health, Department of Medicine, Division of Respirology, McMaster University, Hamilton, Canada
- * E-mail:
| | - Ali Usman
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Yangqing Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou Medical University, Guangzhou, China
| | | | - Michele Zaman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Alex Dragoman
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Steven Jiatong Chen
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Malik Farooqi
- Firestone Institute for Respiratory Health, Department of Medicine, Division of Respirology, McMaster University, Hamilton, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
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Smith JR, Taylor BJ. Inspiratory muscle weakness in cardiovascular diseases: Implications for cardiac rehabilitation. Prog Cardiovasc Dis 2022; 70:49-57. [PMID: 34688670 PMCID: PMC8930518 DOI: 10.1016/j.pcad.2021.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 01/03/2023]
Abstract
Exercise limitation is a cardinal manifestation of many cardiovascular diseases (CVD) and is associated with poor prognosis. It is increasingly well understood that exercise-based cardiac rehabilitation (CR) is an intervention that portends favorable clinical outcomes, including improvements in exercise capacity. The etiology of exercise limitation in CVD is multifactorial but is typically governed by terminal sensations of pain, fatigue, and/or breathlessness. A known but perhaps underestimated complication of CVD that contributes to breathlessness and exercise intolerance in such patients is inspiratory muscle dysfunction. For example, inspiratory muscle dysfunction, which encompasses a loss in muscle mass and/or pressure generating capacity, occurs in up to ~40% of patients with chronic heart failure and is associated with breathlessness, exertional intolerance, and worse survival in this patient population. In this review, we define inspiratory muscle weakness, detail its prevalence in a range of CVDs, and discuss how inspiratory weakness impacts physiological function and clinical outcomes in patients with CVD often referred to CR. We also evaluate the available evidence addressing the effects of exercise-based CR with and without concurrent specific inspiratory muscle training (IMT) on inspiratory muscle function, general physiological function, and clinical outcomes in patients with CVD. Finally, we consider whether the assessment of global respiratory muscle function should become standard as part of the patient intake assessment for phase II CR programs, giving practical guidance on the implementation of such measures as well as IMT as part of phase II CR.
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Affiliation(s)
- Joshua R. Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester MN
| | - Bryan J. Taylor
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL
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34
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Kouri A, Dandurand RJ, Usmani OS, Chow CW. Exploring the 175-year history of spirometry and the vital lessons it can teach us today. Eur Respir Rev 2021; 30:30/162/210081. [PMID: 34615699 DOI: 10.1183/16000617.0081-2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022] Open
Abstract
175 years have elapsed since John Hutchinson introduced the world to his version of an apparatus that had been in development for nearly two centuries, the spirometer. Though he was not the first to build a device that sought to measure breathing and quantify the impact of disease and occupation on lung function, Hutchison coined the terms spirometer and vital capacity that are still in use today, securing his place in medical history. As Hutchinson envisioned, spirometry would become crucial to our growing knowledge of respiratory pathophysiology, from Tiffeneau and Pinelli's work on forced expiratory volumes, to Fry and Hyatt's description of the flow-volume curve. In the 20th century, standardization of spirometry further broadened its reach and prognostic potential. Today, spirometry is recognized as essential to respiratory disease diagnosis, management and research. However, controversy exists in some of its applications, uptake in primary care remains sub-optimal and there are concerns related to the way in which race is factored into interpretation. Moving forward, these failings must be addressed, and innovations like Internet-enabled portable spirometers may present novel opportunities. We must also consider the physiologic and practical limitations inherent to spirometry and further investigate complementary technologies such as respiratory oscillometry and other emerging technologies that assess lung function. Through an exploration of the storied history of spirometry, we can better contextualize its current landscape and appreciate the trends that have repeatedly arisen over time. This may help to improve our current use of spirometry and may allow us to anticipate the obstacles confronting emerging pulmonary function technologies.
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Affiliation(s)
- Andrew Kouri
- Division of Respirology, Dept of Medicine, St. Michael's Hospital, Unity Health Toronto, Ontario, Canada
| | - Ronald J Dandurand
- Lakeshore General Hospital, Quebec, Canada.,Dept of Medicine, Respiratory Division, McGill University, Montreal, Quebec, Canada.,Montreal Chest Institute, Meakins-Christie Labs and Oscillometry Unit of the Centre for Innovative Medicine, McGill University Health Centre and Research Institute, Montreal, Canada
| | - Omar S Usmani
- National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, London, UK
| | - Chung-Wai Chow
- Dept of Medicine, University of Toronto, Toronto, Canada.,Division of Respirology and Multi-Organ Transplant Programme, Dept of Medicine, Toronto General Hospital, University Health Network, Toronto, Canada
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35
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Braun SD, Clayton M, Koschel D, Prescher C, Körndle H, Narciss S. Instructional Training Compared with Self-Study for Pulmonary Function Test Interpretation. ATS Sch 2021; 2:566-80. [PMID: 35079740 PMCID: PMC8751683 DOI: 10.34197/ats-scholar.2021-0035oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Pulmonary diseases have considerable prognostic relevance for all-cause mortality. Most patients with lung diseases such as chronic obstructive pulmonary disease are treated by general practitioners. Understanding the clinical consequences such as pulmonary hyperinflation or reduced diffusion capacity is important for the management and prognosis of patients with chronic respiratory disorders. Therefore, the interpretation of pulmonary function testing (PFT) results needs to see more emphasis in the medical education curriculum. Objective To develop PFT training for final-year medical students and to compare the efficacy of instructional training to self-reliant textbook study. Methods A two-armed randomized control trial compares learning outcomes in PFT interpretation. A total of 25 final-year medical students were selected at random into the 1) instructional training group or 2) self-reliant textbook study group on PFT interpretation. The learning time for both groups was 2 hours. The duration of the written pre- and post-training examinations was 60 minutes each. Both exams had a knowledge section (30 questions, maximum 120 points) and a skills section (11 case studies, maximum 75 points). Results The instructional training group acquired significantly more knowledge and, in particular, higher skill levels when compared with the self-reliant reading group. In the reading group, knowledge scores increased from 48 to 60% (12%) and skills scores increased from 14 to 22% (8%), whereas in the instructional group, knowledge increased from 47 to 71% (24%) and skills from 18 to 58% (40%). A multivariate analysis (Pillai’s Trace: 0.633; P < 0.001) as well as follow-up univariate analyses reveal that these differences are statistically significant (knowledge: F = 8.811, df = 1, P = 0.007; skills F = 33.965, df = 1, P < 0.001). Interestingly, there was no significant group effect in the pure knowledge gain about respiratory disorders per se. Conclusion The self-reliant study group was less able to translate their newly acquired knowledge into interpretation of comprehensive PFT reports. A mandatory 2-hour instructional training greatly enhances the students’ knowledge and skills about PFT interpretation. Obligatory PFT instructional training should therefore be included in the students’ curriculum.
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36
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Yamada M, Motoike IN, Kojima K, Fuse N, Hozawa A, Kuriyama S, Katsuoka F, Tadaka S, Shirota M, Sakurai M, Nakamura T, Hamanaka Y, Suzuki K, Sugawara J, Ogishima S, Uruno A, Kodama EN, Fujino N, Numakura T, Ichikawa T, Mitsune A, Ohe T, Kinoshita K, Ichinose M, Sugiura H, Yamamoto M. Genetic loci for lung function in Japanese adults with adjustment for exhaled nitric oxide levels as airway inflammation indicator. Commun Biol 2021; 4:1288. [PMID: 34782693 PMCID: PMC8593164 DOI: 10.1038/s42003-021-02813-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 10/27/2021] [Indexed: 11/08/2022] Open
Abstract
Lung function reflects the ability of the respiratory system and is utilized for the assessment of respiratory diseases. Because type 2 airway inflammation influences lung function, genome wide association studies (GWAS) for lung function would be improved by adjustment with an indicator of the inflammation. Here, we performed a GWAS for lung function with adjustment for exhaled nitric oxide (FeNO) levels in two independent Japanese populations. Our GWAS with genotype imputations revealed that the RNF5/AGER locus including AGER rs2070600 SNP, which introduces a G82S substitution of AGER, was the most significantly associated with FEV1/FVC. Three other rare missense variants of AGER were further identified. We also found genetic loci with three candidate genes (NOS2, SPSB2 and RIPOR2) associated with FeNO levels. Analyses with the BioBank-Japan GWAS resource revealed genetic links of FeNO and asthma-related traits, and existence of common genetic background for allergic diseases and their biomarkers. Our study identified the genetic locus most strongly associated with airway obstruction in the Japanese population and three genetic loci associated with FeNO, an indicator of type 2 airway inflammation in adults.
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Affiliation(s)
- Mitsuhiro Yamada
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ikuko N Motoike
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kaname Kojima
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Fumiki Katsuoka
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Shu Tadaka
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Matsuyuki Shirota
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Miyuki Sakurai
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Department of Health Record Informatics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Yohei Hamanaka
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kichiya Suzuki
- Department of Biobank, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Junichi Sugawara
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Soichi Ogishima
- Department of Health Record Informatics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan
| | - Akira Uruno
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Eiichi N Kodama
- Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Naoya Fujino
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tadahisa Numakura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomohiro Ichikawa
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ayumi Mitsune
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Ohe
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kengo Kinoshita
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Advanced Research Center for Innovations in Next-Generation Medicine, Tohoku University, Sendai, Japan
- Department of System Bioinformatics, Tohoku University Graduate School of Information Sciences, Sendai, Japan
| | | | - Hisatoshi Sugiura
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Yamamoto
- Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Batajrobeh A, Ahmadi MM, Mogharnasi M. Effects of High and Moderate-Intensity Interval Training on Pulmonary and Performance Parameters in Miners Suffering From Chronic Obstructive Pulmonary Diseases. J Occup Environ Med 2021; 63:e673-e678. [PMID: 34267106 DOI: 10.1097/jom.0000000000002329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To characterize the effect of 12 weeks of high and moderate-intensity interval training on pulmonary and functional parameters in miners with chronic obstructive pulmonary disease working in the polluted environment. METHODS Forty-five miners with COPD (average degree: 60 > FEV1 < 70), were randomly divided into HIIT (with 100%-125% ISWT); MIIT (with 60%-85% ISWT), and control. The study period was 12 weeks (3 sessions per week). At the beginning and end of the study, pulmonary and functional indices was evaluated. RESULTS Based on results, HIIT and MIIT significantly increased FVC, FEV1, and mean traveled distance in ISWT compared with control. Comparison of training intensities showed that HIIT led to a significant change in FVC, FEV1, and ISWT record compared to MIIT. CONCLUSION It is suggested that miners suffering from COPD, consider HIIT as part of their treatment plan.
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Affiliation(s)
- Abdolhakim Batajrobeh
- Department of Sport Sciences, University of Birjand, Birjand, 9717434765. Iran (Mr Batajrobe, Dr Ahmad, and Dr Mogharnasi)
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Yang T, Jackson VE, Smith AV, Chen H, Bartz TM, Sitlani CM, Psaty BM, Gharib SA, O'Connor GT, Dupuis J, Xu J, Lohman K, Liu Y, Kritchevsky SB, Cassano PA, Flexeder C, Gieger C, Karrasch S, Peters A, Schulz H, Harris SE, Starr JM, Deary IJ, Manichaikul A, Oelsner EC, Barr RG, Taylor KD, Rich SS, Bonten TN, Mook-Kanamori DO, Noordam R, Li-Gao R, Jarvelin MR, Wielscher M, Terzikhan N, Lahousse L, Brusselle G, Weiss S, Ewert R, Gläser S, Homuth G, Shrine N, Hall IP, Tobin M, London SJ, Wei P, Morrison AC. Rare and low-frequency exonic variants and gene-by-smoking interactions in pulmonary function. Sci Rep 2021; 11:19365. [PMID: 34588469 DOI: 10.1038/s41598-021-98120-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
Genome-wide association studies have identified numerous common genetic variants associated with spirometric measures of pulmonary function, including forced expiratory volume in one second (FEV1), forced vital capacity, and their ratio. However, variants with lower minor allele frequencies are less explored. We conducted a large-scale gene-smoking interaction meta-analysis on exonic rare and low-frequency variants involving 44,429 individuals of European ancestry in the discovery stage and sought replication in the UK BiLEVE study with 45,133 European ancestry samples and UK Biobank study with 59,478 samples. We leveraged data on cigarette smoking, the major environmental risk factor for reduced lung function, by testing gene-by-smoking interaction effects only and simultaneously testing the genetic main effects and interaction effects. The most statistically significant signal that replicated was a previously reported low-frequency signal in GPR126, distinct from common variant associations in this gene. Although only nominal replication was obtained for a top rare variant signal rs142935352 in one of the two studies, interaction and joint tests for current smoking and PDE3B were significantly associated with FEV1. This study investigates the utility of assessing gene-by-smoking interactions and underscores their effects on potential pulmonary function.
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Ohara DG, Moreira YP, Silva CFR, Matos AP, Gama TO, Jamami M, Pinto ACPN, Pegorari MS. Impaired pulmonary function is associated with dynapenia, but not with abdominal obesity and dynapenic abdominal obesity in older adults. Eur Geriatr Med 2021; 13:475-482. [PMID: 34550559 DOI: 10.1007/s41999-021-00560-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE No studies have previously analyzed the association between dynapenic abdominal obesity (DAO) and pulmonary function in older adults. The aim of this study was to analyze whether there is an association between pulmonary function and abdominal obesity, dynapenia, and DAO in community-dwelling older adults. METHODS A cross-sectional study was conducted with community-dwelling older adults (n = 383) of Macapá, Amapá, Brazil. Pulmonary function variables were evaluated with spirometry; and DAO was evaluated with the combination of dynapenia and abdominal obesity. Cutoff points for handgrip strength, 26 kg force for men and 16 kg force for women, were used to detect dynapenia; and cutoff points of abdominal circumference of > 102 cm for men and > 88 cm for women were used to identify abdominal obesity. RESULTS Most of the studied pulmonary function variables (obtained values and obtained versus predicted values) were associated with abdominal obesity, dynapenia, and DAO. However, in the adjusted model, there was an association of FVC (β = - 0.163; p < 0.001), FEV1 (β = - 0.119; p = 0.006), and PEF (β = - 0.110; p = 0.017) only with dynapenia. CONCLUSIONS Older adults with abdominal obesity, dynapenia, and DAO presented impaired pulmonary function when compared to those without these conditions. Most of the pulmonary function variables were associated with abdominal obesity, dynapenia, and DAO conditions. However, in the adjusted model, there was an association of reduced FVC, FEV1, and PEF values only with dynapenia.
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Affiliation(s)
- Daniela G Ohara
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Yasmin P Moreira
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Caroline F R Silva
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Areolino P Matos
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Tatiana O Gama
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Maurício Jamami
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Carolina P N Pinto
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Maycon S Pegorari
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil.
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Wang J, Dai H, Chen C, Ding G, Zhang Y, Qin Y, Zhang Y, Xiang Q. Relationship between lung function impairment, hypertension, and major adverse cardiovascular events: A 10-year follow-up study. J Clin Hypertens (Greenwich) 2021; 23:1930-1938. [PMID: 34530489 PMCID: PMC8678850 DOI: 10.1111/jch.14364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/21/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
Lung function impairment and hypertension, especially hypertension, are risk factors of major adverse cardiovascular events (MACEs). However, the relationships among lung function impairment, hypertension, and MACEs have not been well‐reported. We aimed to investigate the association between lung function and hypertension and MACEs. We studied 6769 people who were a representative sample of the general population in Jiangsu Province using the multi‐stage stratified cluster sampling method. The average age was 51.54 years. Cox proportional hazards models were used to analyze the relationships between the blood pressure status and various types of lung function impairment related to MACEs. Over a follow‐up of 10 years, 236 MACEs occurred. After adjusting for age, sex, BMI, smoking, drinking, education, physical activity, diabetes mellitus, dyslipidemia, creatine and use of antihypertensive drugs, hypertension [hazard ratio (HR) = 2.154, 95% confidence intervals (CI): 1.565–2.966], and restrictive lung function impairment (RLFI) (HR = 1.398, 95% CI: 1.021–1.879) were independently associated with MACEs. Individuals with hypertension and RFLI had the highest risk for MACEs (HR = 2.930, 95% CI: 1.734–4.953) and stroke (HR = 3.296, 95% CI: 1.862–5.832). Moreover, when combined with hypertension, obstructive lung function impairment (OLFI) (HR = 2.376, 95% CI: 1.391–4.056) and mixed lung function impairment (MLFI) (HR = 2.423, 95% CI: 1.203–4.882) were associated with MACEs. There is a synergistic effect of lung function impairment (especially RLFI) and hypertension on MACEs. Therefore, more attention should be paid to the incidence of MACEs in individuals with impaired lung function, especially those who have hypertension.
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Affiliation(s)
- Jiaqi Wang
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China
| | - He Dai
- Department of Cardiology, Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Chong Chen
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China
| | - Ganling Ding
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China
| | - Yongqing Zhang
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - Yu Qin
- Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China
| | - Yuqing Zhang
- Department of Cardiology, Nanjing Jiangning Hospital, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Quanyong Xiang
- School of Public Health, Southeast University, Nanjing, Jiangsu Province, China.,Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, Jiangsu Province, China
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Bhakta NR, Kaminsky DA, Bime C, Thakur N, Hall GL, McCormack MC, Stanojevic S. Addressing Race in Pulmonary Function Testing by Aligning Intent and Evidence With Practice and Perception. Chest 2021; 161:288-297. [PMID: 34437887 PMCID: PMC8783030 DOI: 10.1016/j.chest.2021.08.053] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/29/2021] [Accepted: 08/17/2021] [Indexed: 10/27/2022] Open
Abstract
The practice of using race or ethnicity in medicine to explain differences between individuals is being called into question because it may contribute to biased medical care and research that perpetuates health disparities and structural racism. A commonly cited example is the use of race or ethnicity in the interpretation of pulmonary function test (PFT) results, yet the perspectives of practicing pulmonologists and physiologists are missing from this discussion. This discussion has global relevance for increasingly multicultural communities in which the range of values that represent normal lung function is uncertain. We review the underlying sources of differences in lung function, including those that may be captured by race or ethnicity, and demonstrate how the current practice of PFT measurement and interpretation is imperfect in its ability to describe accurately the relationship between function and health outcomes. We summarize the arguments against using race-specific equations as well as address concerns about removing race from the interpretation of PFT results. Further, we outline knowledge gaps and critical questions that need to be answered to change the current approach of including race or ethnicity in PFT results interpretation thoughtfully. Finally, we propose changes in interpretation strategies and future research to reduce health disparities.
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Affiliation(s)
- Nirav R Bhakta
- University of California, San Francisco, San Francisco, CA.
| | | | - Christian Bime
- College of Medicine, The University of Arizona Health Science, Tucson, AZ
| | - Neeta Thakur
- University of California, San Francisco, San Francisco, CA; Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Graham L Hall
- Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Allied Health, Curtin University, Perth, WA, Australia
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Cheng YJ, Chen ZG, Yao FJ, Liu LJ, Zhang M, Wu SH. Airflow obstruction, impaired lung function and risk of sudden cardiac death: a prospective cohort study. Thorax 2021; 77:652-662. [PMID: 34417352 DOI: 10.1136/thoraxjnl-2020-215632] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/04/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Growing evidence suggests that compromised lung health may be linked to cardiovascular disease. However, little is known about its association with sudden cardiac death (SCD). OBJECTIVES We aimed to assess the link between impaired lung function, airflow obstruction and risk of SCD by race and gender in four US communities. METHODS A total of 14 708 Atherosclerosis Risk in Communities (ARIC) study participants who underwent spirometry and were asked about lung health (1987-1989) were followed. The main outcome was physician-adjudicated SCD. Fine-Gray proportional subdistribution hazard models with Firth's penalised partial likelihood correction were used to estimate the HRs. RESULTS Over a median follow-up of 25.4 years, 706 (4.8%) subjects experienced SCD. The incidence of SCD was inversely associated with FEV1 in each of the four race and gender groups and across all smoking status categories. After adjusting for multiple measured confounders, HRs of SCD comparing the lowest with the highest quintile of FEV1 were 2.62 (95% CI 1.62 to 4.26) for white males, 1.80 (95% CI 1.03 to 3.15) for white females, 2.07 (95% CI 1.05 to 4.11) for black males and 2.62 (95% CI 1.21 to 5.65) for black females. The above associations were consistently observed among the never smokers. Moderate to very severe airflow obstruction was associated with increased risk of SCD. Addition of FEV1 significantly improved the predictive power for SCD. CONCLUSIONS Impaired lung function and airflow obstruction were associated with increased risk of SCD in general population. Additional research to elucidate the underlying mechanisms is warranted.
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Affiliation(s)
- Yun-Jiu Cheng
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Zhen-Guang Chen
- Department of Thoracic Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Feng-Juan Yao
- Department of Medical Ultrasonics, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Li-Juan Liu
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Ming Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Su-Hua Wu
- Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China .,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
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Ignatius EH, Dooley KE. A leap forward in assessing host-directed therapies for tuberculosis. Lancet Respir Med 2021; 9:809-810. [PMID: 33740467 PMCID: PMC9190060 DOI: 10.1016/s2213-2600(20)30528-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 10/21/2022]
Affiliation(s)
- Elisa H Ignatius
- Divisions of Infectious Diseases and Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Kelly E Dooley
- Divisions of Infectious Diseases and Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Rao VG, Muniyandi M, Sharma RK, Yadav R, Bhat J. Long-term survival of patients treated for tuberculosis: a population-based longitudinal study in a resource-poor setting. Trop Med Int Health 2021; 26:1110-1116. [PMID: 34109699 DOI: 10.1111/tmi.13636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We assessed the long-term survival of TB patients belonging to the Saharia tribe, a high TB burden community in Shivpuri district, Madhya Pradesh, central India. METHODS Population-based, longitudinal study conducted among 9756 Saharia population in 2013, and a resurvey done 2 years later in 2015 using the same methods. The status of the individuals during resurvey was recorded as non-TB, relapse and death. The deaths recorded in this period were used to measure the mortality among TB-affected population and the non-TB population in this cohort. RESULTS The standardised mortality ratio for the study cohort was 122.9 per 1000 population; males had higher mortality than females (129.9 vs. 96.8). The expected mortality among the non-TB population was 30.2, and the observed mortality among TB-affected population was 122.9 per 1000 population. CONCLUSION In the Saharia tribe, post-treatment mortality in the TB-affected population is significantly higher than in the general population. This highlights an urgent need for implementation of effective public health strategies to prevent disproportionate deaths among TB-affected individuals in resource-poor settings, and the importance of periodic follow-up of patients after cure/completion of treatment, especially in vulnerable populations.
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Affiliation(s)
- V G Rao
- National Institute of Research in Tribal Health, Jabalpur, India
| | - M Muniyandi
- National Institute for Research in Tuberculosis, Chennai, India
| | - R K Sharma
- National Institute of Medical Statistics, New Delhi, India
| | - R Yadav
- National Institute of Research in Tribal Health, Jabalpur, India
| | - Jyothi Bhat
- National Institute of Research in Tribal Health, Jabalpur, India
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Agusti A, Fabbri LM, Baraldi E, Celli B, Corradi M, Faner R, Martinez FD, Melén E, Papi A. Spirometry: A practical lifespan predictor of global health and chronic respiratory and non-respiratory diseases. Eur J Intern Med 2021; 89:3-9. [PMID: 34016514 DOI: 10.1016/j.ejim.2021.04.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/28/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVES 1. To review and discuss available evidence supporting that spirometry is an overlooked global health marker, that could be used regularly through the lifespan to monitor human health and predict risk of chronic respiratory and other chronic non-communicable diseases (NCDs). 2. To discuss the challenges and opportunities that this proposal faces.Summary of key data. First, spirometry is essential to assess and monitor respiratory health. Second, spirometry adds prognostic value to other well-accepted health markers used in clinical practice, such as blood pressure, body mass index, glucose and blood lipids, by identifying individuals at risk, not only of respiratory diseases, but also of other NCDs, particularly cardiovascular and metabolic disorders. CONCLUSION Although we acknowledge that research gaps still exist, we propose that spirometry assessed during childhood, adolescence and early and late adulthood can be a reproducible, non-invasive, safe and affordable global health marker to identify individuals in the general population at risk of respiratory and non-respiratory NCDs. In this context, spirometry may act as the caged canaries that miners used to carry into mines to alert them of dangerous accumulations of gases, thus providing an early warning and save lives.
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Affiliation(s)
- Alvar Agusti
- Cátedra Salud Respiratoria, University of Barcelona, Spain; Respiratory Institute, Hospital Clinic, C/Villarroel 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain.
| | - Leonardo M Fabbri
- Section of Respiratory Medicine, Translational Medicine & Romagna, University of Ferrara, Ferrara, Italy
| | - Eugenio Baraldi
- Department of Women's and Children's Health, Neonatal Intensive Care Unit and Institute of Pediatric Research, University of Padova, Padova, Italy
| | | | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Rosa Faner
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain
| | - Fernando D Martinez
- Asthma & Airway Disease Research Center, University of Arizona, Tucson, AZ, USA
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Sachs' Children's Hospital, Stockholm, Sweden
| | - Alberto Papi
- Respiratory Medicine, University of Ferrara; Emergency Department, University Hospital S. Anna, Ferrara, Italy
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Shah CH, Reed RM, Liang Y, Zafari Z. Association between lung function and future risks of diabetes, asthma, myocardial infarction, hypertension and all-cause mortality. ERJ Open Res 2021; 7:00178-2021. [PMID: 34549046 PMCID: PMC8450454 DOI: 10.1183/23120541.00178-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/04/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND While forced expiratory volume in 1 s (FEV1) is a hallmark of disease progression in chronic obstructive lung diseases, little is known about the relationship between baseline FEV1 and future risks of other medical conditions. OBJECTIVE The aim of this study was to investigate the association between baseline FEV1 and future risks of diabetes, asthma, myocardial infarction, hypertension and all-cause mortality. METHODS We used data from the National Health and Nutrition Examination Survey and its Epidemiological Follow-Up Study. Our data provided longitudinal follow-up of the original cohort for up to 12 years. We used two competing risks approaches, the cause-specific hazard model and the Fine-Gray sub-distribution hazard model, to measure the associations between baseline FEV1 and future risks of the outcomes of interest. All models were adjusted for major confounding factors. RESULTS The final sample included 3020 participants (mean±sd baseline age 44.64±13.44 years). In the cause-specific hazard model, for every per cent increase in the baseline per cent predicted FEV1, the hazard of the event reduced by 2.5% (HR 0.975; 95% CI 0.958-0.994) for diabetes, 4.3% (HR 0.957; 95% CI 0.932-0.983) for asthma and 1.8% (HR 0.982; 95% CI 0.971-0.992) for all-cause mortality. There was no statistically significant association between baseline per cent predicted FEV1 and future risks of myocardial infarction (HR 0.987; 95% CI 0.970-1.004) and hypertension (HR 0.998; 95% CI 0.992-1.005). Consistent results were observed for the Fine-Gray sub-distribution hazard model. CONCLUSION Our data suggest that lower per cent predicted FEV1 values at baseline were significantly associated with higher future risks of diabetes, asthma and all-cause mortality.
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Affiliation(s)
- Chintal H. Shah
- Dept of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Robert M. Reed
- Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yulan Liang
- Dept of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Zafar Zafari
- Dept of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
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PARK RM. Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies. Saf Health Work 2021; 12:174-183. [PMID: 34178394 PMCID: PMC8209360 DOI: 10.1016/j.shaw.2020.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Toluene diisocyanate (TDI) is a highly reactive chemical that causes sensitization and has also been associated with increased lung cancer. A risk assessment was conducted based on occupational epidemiologic estimates for several health outcomes. METHODS Exposure and outcome details were extracted from published studies and a NIOSH Health Hazard Evaluation for new onset asthma, pulmonary function measurements, symptom prevalence, and mortality from lung cancer and respiratory disease. Summary exposure-response estimates were calculated taking into account relative precision and possible survivor selection effects. Attributable incidence of sensitization was estimated as were annual proportional losses of pulmonary function. Excess lifetime risks and benchmark doses were calculated. RESULTS Respiratory outcomes exhibited strong survivor bias. Asthma/sensitization exposure response decreased with increasing facility-average TDI air concentration as did TDI-associated pulmonary impairment. In a mortality cohort where mean employment duration was less than 1 year, survivor bias pre-empted estimation of lung cancer and respiratory disease exposure response. CONCLUSION Controlling for survivor bias and assuming a linear dose-response with facility-average TDI concentrations, excess lifetime risks exceeding one per thousand occurred at about 2 ppt TDI for sensitization and respiratory impairment. Under alternate assumptions regarding stationary and cumulative effects, one per thousand excess risks were estimated at TDI concentrations of 10 - 30 ppt. The unexplained reported excess mortality from lung cancer and other lung diseases, if attributable to TDI or associated emissions, could represent a lifetime risk comparable to that of sensitization.
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Affiliation(s)
- Robert M. PARK
- Division of Science Integration, Risk Evaluation Branch, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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48
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Johnston JE, Enebish T, Eckel SP, Navarro S, Shamasunder B. Respiratory health, pulmonary function and local engagement in urban communities near oil development. Environ Res 2021; 197:111088. [PMID: 33794173 PMCID: PMC8579779 DOI: 10.1016/j.envres.2021.111088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Modern oil development frequently occurs in close proximity to human populations. Los Angeles, California is home to the largest urban oil field in the country with thousands of active oil and gas wells in very close proximity to homes, schools and parks, yet few studies have investigated potential health impacts. The neighborhoods along the Las Cienagas oil fields are situated in South LA, densely populated by predominantly low-income Black and Latinx families, many of whom are primarily Spanish-speakers. METHODS A cross-sectional community-based study was conducted between January 2017 and August 2019 among residents living <1000 m from two oil wells (one active, one idle) in the Las Cienagas oil field. We collected self-reported acute health symptoms and measured FEV1 (forced expiratory volume in the first second of exhalation) and FVC (forced vital capacity). We related lung function measures to distance and direction from an oil and gas development site using generalized linear models adjusted for covariates. RESULTS A total of 961 residents from two neighborhoods participated, the majority of whom identify as Latinx. Participants near active oil development reported significantly higher prevalence of wheezing, eye and nose irritation, sore throat and dizziness in the past 2 weeks. Among 747 valid spirometry tests, we observe that living near (less than 200 m) of oil operations was associated with, on average, -112 mL lower FEV1 (95% CI: -213, -10) and -128 mL lower FVC (95% CI: -252, -5) compared to residents living more than 200 m from the sites after adjustments for covariates, including age, sex, height, proximity to freeway, asthma status and smoking status. When accounting for predominant wind direction and proximity, we observe that residents living downwind and less than 200 m from oil operations have, on average, -414 mL lower FEV1 (95% CI: -636, -191) and -400 mL lower FVC (95% CI: -652, -147) compared to residents living upwind and more than 200 m from the wells. CONCLUSIONS Living nearby and downwind of urban oil and gas development sites is associated with lower lung function among residents, which may contribute to environmental health disparities.
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Affiliation(s)
- Jill E Johnston
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Temuulen Enebish
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Bhavna Shamasunder
- Department of Urban & Environmental Policy, Occidental College, Los Angeles, CA, USA
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Alhamdow A, Zettergren A, Kull I, Hallberg J, Andersson N, Ekström S, Berglund M, Wheelock CE, Essig YJ, Krais AM, Georgelis A, Lindh CH, Melén E, Bergström A. Low-level exposure to polycyclic aromatic hydrocarbons is associated with reduced lung function among Swedish young adults. Environ Res 2021; 197:111169. [PMID: 33857464 DOI: 10.1016/j.envres.2021.111169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/15/2021] [Accepted: 04/08/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Exposure to polycyclic aromatic hydrocarbons (PAHs) has been linked to adverse pulmonary effects. However, the impact of low-level environmental PAH exposure on lung function in early adulthood remains uncertain. OBJECTIVES To evaluate the associations between urinary PAH metabolites and lung function parameters in young adults. METHODS Urinary metabolites of pyrene, phenanthrene, and fluorene were analysed in 1000 young adults from Sweden (age 22-25 years) using LC-MS/MS. Lung function and eosinophilic airway inflammation were measured by spirometry and exhaled nitric oxide fraction (FeNO), respectively. Linear regression analysis was used to evaluate associations between PAH metabolites and the outcomes. RESULTS Median urinary concentrations of 1-OH-pyrene, ∑OH-phenanthrene, and ∑OH-fluorene were 0.066, 0.36, 0.22 μg/L, respectively. We found inverse associations of ∑OH-phenanthrene and ∑OH-fluorene with FEV1 and FVC, as well as between 1-OH-pyrene and FEV1/FVC ratio (adjusted P < 0.05; all participants). An increase of 1% in ∑OH-fluorene was associated with a decrease of 73 mL in FEV1 and 59 mL in FVC. In addition, ∑OH-phenanthrene concentrations were, in a dose-response manner, inversely associated with FEV1 (B from -109 to -48 compared with the lowest quartile of ∑OH-phenanthrene; p trend 0.004) and FVC (B from -159 to -102 compared with lowest quartile; p-trend <0.001). Similar dose-response associations were also observed between ∑OH-fluorene and FEV1 and FVC, as well as between 1-OH-pyrene and FEV1/FVC (p-trend <0.05). There was no association between PAH exposure and FeNO, nor was there an interaction with smoking, sex, or asthma. CONCLUSION Low-level PAH exposure was, in a dose-response manner, associated with reduced lung function in young adults. Our findings have public health implications due to i) the widespread occurrence of PAHs in the environment and ii) the clinical relevance of lung function in predicting all-cause and cardiovascular disease mortality.
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Affiliation(s)
- Ayman Alhamdow
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Anna Zettergren
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE, 11883, Stockholm, Sweden
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden
| | - Craig E Wheelock
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institute, SE-171 77, Department of Respiratory Medicine and Allergy, Karolinska University Hospital, SE, 17165, Stockholm, Sweden
| | - Yona J Essig
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Annette M Krais
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Antonios Georgelis
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden
| | - Christian H Lindh
- Division of Occupational and Environmental Medicine, Lund University, SE, 22363, Lund, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Sachs' Children's and Youth Hospital, Södersjukhuset, SE, 11883, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE, 11883, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, SE, 17177, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, SE, 11365, Stockholm, Sweden.
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Duan H, Liang L, Liu X, Xie S, Wang C. PARC/CCL18 is Associated with Inflammation, Emphysema Severity and Application of Inhaled Corticosteroids in Hospitalized COPD Patients. Int J Chron Obstruct Pulmon Dis 2021; 16:1287-1297. [PMID: 34007168 PMCID: PMC8121623 DOI: 10.2147/copd.s304488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background Pulmonary and activation-regulated chemokine (PARC) also named CC-chemokine ligand 18 (CCL18) is a lung-predominant inflammatory protein that is found in serum. The relationship of PARC/CCL18 with the chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study is to analyze the expression of PARC/CCL18 in COPD. Methods Ninety-eight hospitalized COPD patients and 60 healthy volunteers from January 2019 to December 2019 were recruited in this retrospective study. Gender, age, height, weight, disease duration, smoking status, blood cell classification and count, length of hospital stay (LOS), symptom score, including COPD Assessment Test (CAT) score, modified British Medical Research Council (mMRC) score, lung function and therapy were recorded and serum PARC/CCL18 was analyzed by ELISA. The correlation between symptom score, blood cell classification and count, CRP, lung function parameters and serum levels of PARC/CCL18 and ROC curves of PARC/CCL18 levels and inhaled corticosteroids (ICS) were accessed. Results It was found that serum PARC/CCL18 level in hospitalized COPD population was significantly higher than that in healthy people (p=0.003). COPD patients with emphysema had significantly higher serum level of PARC/CCL18 than those without emphysema (p=0.049). Total lung capacity (TLC) and residual volume (RV)/TLC had positive correlation with serum level of PARC/CCL18 (p=0.001, 0.020, respectively). Furthermore, serum PARC/CCL18 level was predictive for the application ICS (p=0.003) and related to C-reactive protein (p <0.0001) in hospitalized COPD patients. Conclusion PARC/CCL18 is associated with the severity of inflammation and emphysema in COPD. Furthermore, PARC/CCL18 is a predictor of ICS application in the treatment of hospitalized COPD patients.
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Affiliation(s)
- Hongxia Duan
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Long Liang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Xinyang Liu
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Shuanshuan Xie
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Changhui Wang
- Department of Respiratory Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
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