TY - JOUR
T1 - High attenuation areas on chest computed tomography in communitydwelling adults
T2 - The MESA study
AU - Podolanczuk, Anna J.
AU - Oelsner, Elizabeth C.
AU - Barr, R. Graham
AU - Hoffman, Eric A.
AU - Armstrong, Hilary F.
AU - Austin, John H.M.
AU - Basner, Robert C.
AU - Bartels, Matthew N.
AU - Christie, Jason D.
AU - Enright, Paul L.
AU - Gochuico, Bernadette R.
AU - Stukovsky, Karen Hinckley
AU - Kaufman, Joel D.
AU - Nath, P. Hrudaya
AU - Newell, John D.
AU - Palmer, Scott M.
AU - Rabinowitz, Dan
AU - Raghu, Ganesh
AU - Sell, Jessica L.
AU - Sieren, Jered
AU - Sonavane, Sushil K.
AU - Tracy, Russell P.
AU - Watts, Jubal R.
AU - Williams, Kayleen
AU - Kawut, Steven M.
AU - Lederer, David J.
N1 - Publisher Copyright:
Copyright © 2016 ERS.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - 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.
AB - 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.
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U2 - 10.1183/13993003.00129-2016
DO - 10.1183/13993003.00129-2016
M3 - Article
C2 - 27471206
AN - SCOPUS:84994220086
SN - 0903-1936
VL - 48
SP - 1442
EP - 1452
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 5
ER -