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Eur Respir J. 2016 Nov;48(5):1442-1452. doi: 10.1183/13993003.00129-2016. Epub 2016 Jul 28.

High attenuation areas on chest computed tomography in community-dwelling adults: the MESA study.

Author information

1
Dept of Medicine, Columbia University Medical Center, New York, NY, USA.
2
Both authors contributed equally to this work.
3
Dept of Epidemiology, Columbia University Medical Center, New York, NY, USA.
4
Depts of Radiology, Medicine and Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
5
Dept of Radiology, Columbia University Medical Center, New York, NY, USA.
6
Dept of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
7
Dept of Medicine and the Center for Translational Lung Biology, University of Pennsylvania, Philadelphia, PA, USA.
8
Dept of Epidemiology, University of Arizona, Tucson, AZ, USA.
9
National Human Genome Research Institute, Bethesda, MD, USA.
10
Dept of Biostatistics, University of Washington, Seattle, WA, USA.
11
Dept of Medicine, University of Washington, Seattle, WA, USA.
12
Dept of Radiology, University of Alabama, South Birmingham, AL, USA.
13
Duke Clinical Research Institute, Duke University, Durham, NC, USA.
14
Dept of Statistics, Columbia University, New York, NY, USA.
15
VIDA Diagnostics, Inc., Coralville, IA, USA.
16
Dept of Pathology, University of Vermont, Colchester, VT, USA.
17
Dept of Medicine and the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
18
Dept of Medicine, Columbia University Medical Center, New York, NY, USA davidlederer@columbia.edu.

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.

PMID:
27471206
PMCID:
PMC5089905
DOI:
10.1183/13993003.00129-2016
[Indexed for MEDLINE]
Free PMC Article

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