Metabolic Syndrome Biomarkers of World Trade Center Airway Hyperreactivity: A 16-Year Prospective Cohort Study

Sophia Kwon, George Crowley, Mena Mikhail, Rachel Lam, Emily Clementi, Rachel Zeig-Owens, Theresa M. Schwartz, Mengling Liu, David J. Prezant, Anna Nolan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Airway hyperreactivity (AHR) related to environmental exposure is a significant public health risk worldwide. Similarly, metabolic syndrome (MetSyn), a risk factor for obstructive airway disease (OAD) and systemic inflammation, is a significant contributor to global adverse health. This prospective cohort study followed N = 7486 World Trade Center (WTC)-exposed male firefighters from 11 September 2001 (9/11) until 1 August 2017 and investigated N = 539 with newly developed AHR for clinical biomarkers of MetSyn and compared them to the non-AHR group. Male firefighters with normal lung function and no AHR pre-9/11 who had blood drawn from 9 September 2001-24 July 2002 were assessed. World Trade Center-Airway Hyperreactivity (WTC-AHR) was defined as either a positive bronchodilator response (BDR) or methacholine challenge test (MCT). The electronic medical record (EMR) was queried for their MetSyn characteristics (lipid profile, body mass index (BMI), glucose), and routine clinical biomarkers (such as complete blood counts). We modeled the association of MetSyn characteristics at the first post-9/11 exam with AHR. Those with AHR were significantly more likely to be older, have higher BMIs, have high intensity exposure, and have MetSyn. Smoking history was not associated with WTC-AHR. Those present on the morning of 9/11 had 224% increased risk of developing AHR, and those who arrived in the afternoon of 9/11 had a 75.9% increased risk. Having ≥3 MetSyn parameters increased the risk of WTC-AHR by 65.4%. Co-existing MetSyn and high WTC exposure are predictive of future AHR and suggest that systemic inflammation may be a contributor.

Original languageEnglish (US)
JournalInternational journal of environmental research and public health
Volume16
Issue number9
DOIs
StatePublished - Apr 26 2019

Fingerprint

Cohort Studies
Biomarkers
Prospective Studies
Firefighters
Inflammation
Blood Cell Count
Methacholine Chloride
Electronic Health Records
Bronchodilator Agents
Environmental Exposure
Body Mass Index
Public Health
Smoking
History
Lipids
Glucose
Lung

Keywords

  • airway hyperreactivity
  • metabolic syndrome
  • World Trade Center

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Metabolic Syndrome Biomarkers of World Trade Center Airway Hyperreactivity : A 16-Year Prospective Cohort Study. / Kwon, Sophia; Crowley, George; Mikhail, Mena; Lam, Rachel; Clementi, Emily; Zeig-Owens, Rachel; Schwartz, Theresa M.; Liu, Mengling; Prezant, David J.; Nolan, Anna.

In: International journal of environmental research and public health, Vol. 16, No. 9, 26.04.2019.

Research output: Contribution to journalArticle

Kwon, Sophia ; Crowley, George ; Mikhail, Mena ; Lam, Rachel ; Clementi, Emily ; Zeig-Owens, Rachel ; Schwartz, Theresa M. ; Liu, Mengling ; Prezant, David J. ; Nolan, Anna. / Metabolic Syndrome Biomarkers of World Trade Center Airway Hyperreactivity : A 16-Year Prospective Cohort Study. In: International journal of environmental research and public health. 2019 ; Vol. 16, No. 9.
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AB - Airway hyperreactivity (AHR) related to environmental exposure is a significant public health risk worldwide. Similarly, metabolic syndrome (MetSyn), a risk factor for obstructive airway disease (OAD) and systemic inflammation, is a significant contributor to global adverse health. This prospective cohort study followed N = 7486 World Trade Center (WTC)-exposed male firefighters from 11 September 2001 (9/11) until 1 August 2017 and investigated N = 539 with newly developed AHR for clinical biomarkers of MetSyn and compared them to the non-AHR group. Male firefighters with normal lung function and no AHR pre-9/11 who had blood drawn from 9 September 2001-24 July 2002 were assessed. World Trade Center-Airway Hyperreactivity (WTC-AHR) was defined as either a positive bronchodilator response (BDR) or methacholine challenge test (MCT). The electronic medical record (EMR) was queried for their MetSyn characteristics (lipid profile, body mass index (BMI), glucose), and routine clinical biomarkers (such as complete blood counts). We modeled the association of MetSyn characteristics at the first post-9/11 exam with AHR. Those with AHR were significantly more likely to be older, have higher BMIs, have high intensity exposure, and have MetSyn. Smoking history was not associated with WTC-AHR. Those present on the morning of 9/11 had 224% increased risk of developing AHR, and those who arrived in the afternoon of 9/11 had a 75.9% increased risk. Having ≥3 MetSyn parameters increased the risk of WTC-AHR by 65.4%. Co-existing MetSyn and high WTC exposure are predictive of future AHR and suggest that systemic inflammation may be a contributor.

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