Validation of Predictive Metabolic Syndrome Biomarkers of World Trade Center Lung Injury

A 16-Year Longitudinal Study

Sophia Kwon, George Crowley, Erin J. Caraher, Syed Hissam Haider, Rachel Lam, Arul Veerappan, Lei Yang, Mengling Liu, Rachel Zeig-Owens, Theresa M. Schwartz, David J. Prezant, Anna Nolan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Metabolic syndrome (MetSyn) predicted future development of World Trade Center lung injury (WTC-LI) in a subgroup of firefighters who never smoked and were male. An intracohort validation of MetSyn as a predictor of WTC-LI is examined in the cohort exposed to the World Trade Center (WTC) that has been followed longitudinally for 16 years. Methods: Results of pulmonary function tests (n = 98,221) in workers exposed to the WTC (n = 9,566) were evaluated. A baseline cohort of firefighters who had normal FEV1 before 9/11 and who had had serum drawn before site closure on July 24, 2002 (n = 7,487) was investigated. Case subjects with WTC-LI (n = 1,208) were identified if they had at least two measured instances of FEV1 less than the lower limit of normal (LLN). Cox proportional hazards modeled early MetSyn biomarker ability to predict development of FEV1 less than the LLN. Results: Case subjects were more likely to smoke, be highly exposed, and have MetSyn. There was a significant exposure dose response; the individuals most highly exposed had a 30.1% increased risk of developing WTC-LI, having MetSyn increased risk of developing WTC-LI by 55.7%, and smoking increased risk by 15.2%. There was significant interaction between smoking and exposure. Conclusions: We validated the usefulness of MetSyn to predict future WTC-LI in a larger population of individuals who were exposed. MetSyn defined by dyslipidemia, insulin resistance, and cardiovascular disease suggests that systemic inflammation can contribute to future lung function loss.

Original languageEnglish (US)
Pages (from-to)486-496
Number of pages11
JournalChest
Volume156
Issue number3
DOIs
StatePublished - Sep 1 2019

Fingerprint

Lung Injury
Longitudinal Studies
Biomarkers
Firefighters
Smoking
Aptitude
Respiratory Function Tests
Dyslipidemias
Smoke
Insulin Resistance
Cardiovascular Diseases
Inflammation
Lung
Serum
Population

Keywords

  • lung injury
  • metabolic syndrome
  • validation
  • World Trade Center

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kwon, S., Crowley, G., Caraher, E. J., Haider, S. H., Lam, R., Veerappan, A., ... Nolan, A. (2019). Validation of Predictive Metabolic Syndrome Biomarkers of World Trade Center Lung Injury: A 16-Year Longitudinal Study. Chest, 156(3), 486-496. https://doi.org/10.1016/j.chest.2019.02.019

Validation of Predictive Metabolic Syndrome Biomarkers of World Trade Center Lung Injury : A 16-Year Longitudinal Study. / Kwon, Sophia; Crowley, George; Caraher, Erin J.; Haider, Syed Hissam; Lam, Rachel; Veerappan, Arul; Yang, Lei; Liu, Mengling; Zeig-Owens, Rachel; Schwartz, Theresa M.; Prezant, David J.; Nolan, Anna.

In: Chest, Vol. 156, No. 3, 01.09.2019, p. 486-496.

Research output: Contribution to journalArticle

Kwon, S, Crowley, G, Caraher, EJ, Haider, SH, Lam, R, Veerappan, A, Yang, L, Liu, M, Zeig-Owens, R, Schwartz, TM, Prezant, DJ & Nolan, A 2019, 'Validation of Predictive Metabolic Syndrome Biomarkers of World Trade Center Lung Injury: A 16-Year Longitudinal Study', Chest, vol. 156, no. 3, pp. 486-496. https://doi.org/10.1016/j.chest.2019.02.019
Kwon, Sophia ; Crowley, George ; Caraher, Erin J. ; Haider, Syed Hissam ; Lam, Rachel ; Veerappan, Arul ; Yang, Lei ; Liu, Mengling ; Zeig-Owens, Rachel ; Schwartz, Theresa M. ; Prezant, David J. ; Nolan, Anna. / Validation of Predictive Metabolic Syndrome Biomarkers of World Trade Center Lung Injury : A 16-Year Longitudinal Study. In: Chest. 2019 ; Vol. 156, No. 3. pp. 486-496.
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abstract = "Background: Metabolic syndrome (MetSyn) predicted future development of World Trade Center lung injury (WTC-LI) in a subgroup of firefighters who never smoked and were male. An intracohort validation of MetSyn as a predictor of WTC-LI is examined in the cohort exposed to the World Trade Center (WTC) that has been followed longitudinally for 16 years. Methods: Results of pulmonary function tests (n = 98,221) in workers exposed to the WTC (n = 9,566) were evaluated. A baseline cohort of firefighters who had normal FEV1 before 9/11 and who had had serum drawn before site closure on July 24, 2002 (n = 7,487) was investigated. Case subjects with WTC-LI (n = 1,208) were identified if they had at least two measured instances of FEV1 less than the lower limit of normal (LLN). Cox proportional hazards modeled early MetSyn biomarker ability to predict development of FEV1 less than the LLN. Results: Case subjects were more likely to smoke, be highly exposed, and have MetSyn. There was a significant exposure dose response; the individuals most highly exposed had a 30.1{\%} increased risk of developing WTC-LI, having MetSyn increased risk of developing WTC-LI by 55.7{\%}, and smoking increased risk by 15.2{\%}. There was significant interaction between smoking and exposure. Conclusions: We validated the usefulness of MetSyn to predict future WTC-LI in a larger population of individuals who were exposed. MetSyn defined by dyslipidemia, insulin resistance, and cardiovascular disease suggests that systemic inflammation can contribute to future lung function loss.",
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AU - Haider, Syed Hissam

AU - Lam, Rachel

AU - Veerappan, Arul

AU - Yang, Lei

AU - Liu, Mengling

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AU - Schwartz, Theresa M.

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AU - Nolan, Anna

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N2 - Background: Metabolic syndrome (MetSyn) predicted future development of World Trade Center lung injury (WTC-LI) in a subgroup of firefighters who never smoked and were male. An intracohort validation of MetSyn as a predictor of WTC-LI is examined in the cohort exposed to the World Trade Center (WTC) that has been followed longitudinally for 16 years. Methods: Results of pulmonary function tests (n = 98,221) in workers exposed to the WTC (n = 9,566) were evaluated. A baseline cohort of firefighters who had normal FEV1 before 9/11 and who had had serum drawn before site closure on July 24, 2002 (n = 7,487) was investigated. Case subjects with WTC-LI (n = 1,208) were identified if they had at least two measured instances of FEV1 less than the lower limit of normal (LLN). Cox proportional hazards modeled early MetSyn biomarker ability to predict development of FEV1 less than the LLN. Results: Case subjects were more likely to smoke, be highly exposed, and have MetSyn. There was a significant exposure dose response; the individuals most highly exposed had a 30.1% increased risk of developing WTC-LI, having MetSyn increased risk of developing WTC-LI by 55.7%, and smoking increased risk by 15.2%. There was significant interaction between smoking and exposure. Conclusions: We validated the usefulness of MetSyn to predict future WTC-LI in a larger population of individuals who were exposed. MetSyn defined by dyslipidemia, insulin resistance, and cardiovascular disease suggests that systemic inflammation can contribute to future lung function loss.

AB - Background: Metabolic syndrome (MetSyn) predicted future development of World Trade Center lung injury (WTC-LI) in a subgroup of firefighters who never smoked and were male. An intracohort validation of MetSyn as a predictor of WTC-LI is examined in the cohort exposed to the World Trade Center (WTC) that has been followed longitudinally for 16 years. Methods: Results of pulmonary function tests (n = 98,221) in workers exposed to the WTC (n = 9,566) were evaluated. A baseline cohort of firefighters who had normal FEV1 before 9/11 and who had had serum drawn before site closure on July 24, 2002 (n = 7,487) was investigated. Case subjects with WTC-LI (n = 1,208) were identified if they had at least two measured instances of FEV1 less than the lower limit of normal (LLN). Cox proportional hazards modeled early MetSyn biomarker ability to predict development of FEV1 less than the LLN. Results: Case subjects were more likely to smoke, be highly exposed, and have MetSyn. There was a significant exposure dose response; the individuals most highly exposed had a 30.1% increased risk of developing WTC-LI, having MetSyn increased risk of developing WTC-LI by 55.7%, and smoking increased risk by 15.2%. There was significant interaction between smoking and exposure. Conclusions: We validated the usefulness of MetSyn to predict future WTC-LI in a larger population of individuals who were exposed. MetSyn defined by dyslipidemia, insulin resistance, and cardiovascular disease suggests that systemic inflammation can contribute to future lung function loss.

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