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

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

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Exercise
  • Extracellular Matrix / metabolism
  • Female
  • Fibrosis
  • Humans
  • Inflammation
  • Interleukin-6 / blood
  • Lung / diagnostic imaging*
  • Lung / physiopathology
  • Lung Diseases, Interstitial / blood
  • Lung Diseases, Interstitial / diagnostic imaging
  • Male
  • Matrix Metalloproteinase 7 / blood
  • Middle Aged
  • Proportional Hazards Models
  • Radiography, Thoracic*
  • Smoking
  • Spirometry / methods
  • Tomography, X-Ray Computed*

Substances

  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • C-Reactive Protein
  • MMP7 protein, human
  • Matrix Metalloproteinase 7

Grant support