High attenuation areas on chest computed tomography in communitydwelling adults: The MESA study

Anna J. Podolanczuk, Elizabeth C. Oelsner, R. Graham Barr, Eric A. Hoffman, Hilary F. Armstrong, John H.M. Austin, Robert C. Basner, Matthew N. Bartels, Jason D. Christie, Paul L. Enright, Bernadette R. Gochuico, Karen Hinckley Stukovsky, Joel D. Kaufman, P. Hrudaya Nath, John D. Newell, Scott M. Palmer, Dan Rabinowitz, Ganesh Raghu, Jessica L. Sell, Jered SierenSushil K. Sonavane, Russell P. Tracy, Jubal R. Watts, Kayleen Williams, Steven M. Kawut, David J. Lederer

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Evidence suggests that lung injury, inflammation and extracellular matrix remodelling precede lung fibrosis in interstitial lung disease (ILD). We examined whether a quantitative measure of increased lung attenuation on computed tomography (CT) detects lung injury, inflammation and extracellular matrix remodelling in community-dwelling adults sampled without regard to respiratory symptoms or smoking. We measured high attenuation areas (HAA; percentage of lung voxels between -600 and -250 Hounsfield Units) on cardiac CT scans of adults enrolled in the Multi-Ethnic Study of Atherosclerosis. HAA was associated with higher serum matrix metalloproteinase-7 (mean adjusted difference 6.3% per HAA doubling, 95% CI 1.3-11.5), higher interleukin-6 (mean adjusted difference 8.8%, 95% CI 4.8-13.0), lower forced vital capacity (FVC) (mean adjusted difference -82 mL, 95% CI -119-44), lower 6-min walk distance (mean adjusted difference -40 m, 95% CI -1-80), higher odds of interstitial lung abnormalities at 9.5 years (adjusted OR 1.95, 95% CI 1.43-2.65), and higher all cause-mortality rate over 12.2 years (HR 1.58, 95% CI 1.39-1.79). High attenuation areas are associated with biomarkers of inflammation and extracellular matrix remodelling, reduced lung function, interstitial lung abnormalities, and a higher risk of death among community-dwelling adults.

Original languageEnglish (US)
Pages (from-to)1442-1452
Number of pages11
JournalEuropean Respiratory Journal
Volume48
Issue number5
DOIs
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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