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Inflammatory Markers and Longitudinal Lung Function Decline in the Elderly

2008; Oxford University Press; Volume: 168; Issue: 6 Linguagem: Inglês

10.1093/aje/kwn174

1476-6256

Rui Jiang, Gregory L. Burke, Paul Enright, Anne B. Newman, Helene G. Margolis, Mary Cushman, Russell P. Tracy, Ying Wang, R. A. Kronmal, R. Graham Barr,

Body Composition Measurement Techniques

Longitudinal studies examining associations of the inflammatory markers fibrinogen and C-reactive protein (CRP) with lung function decline are sparse.The authors examined whether elevated fibrinogen and CRP levels were associated with greater longitudinal lung function decline in the elderly.The Cardiovascular Health Study measured fibrinogen and CRP in 5,790 Whites and African Americans from four US communities aged 65 years or older in 1989 -1990 or 1992-1993 .Spirometry was performed in 1989 -1990 and 4, 7, and 16 and 4, 7, and 16 years later.Fibrinogen and CRP were inversely associated with lung function at baseline after adjustment for multiple potential confounders.In mixed models, the rate of decline in forced expiratory volume in 1 second (FEV 1 )/forced vital capacity (FVC) ratio with increasing age was faster among those with higher baseline fibrinogen (À0.032%/year per standard deviation higher fibrinogen (95% confidence interval: À0.057, À0.0074)) but not among those with higher CRP (À0.0037%/year per standard deviation higher CRP (95% confidence interval: À0.013, 0.0056)).Longitudinal analyses for FEV 1 and FVC yielded results in the direction opposite of that hypothesized, possibly because of the high mortality rate and strong inverse association of FEV 1 and FVC but not FEV 1 /FVC with mortality.An alternative approach to missing data yielded similar results.In conclusion, higher levels of fibrinogen, but not CRP, independently predicted greater FEV 1 /FVC decline in the elderly.aged; biological markers; C-reactive protein; fibrinogen; forced expiratory volume; inflammation; spirometry; vital capacity Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; FEV 1 , forced expiratory volume in 1 second; FVC, forced vital capacity.Lung function deteriorates gradually throughout adult life.Accelerated decline in forced expiratory volume in 1 second (FEV 1 ) and the ratio of FEV 1 /forced vital capacity (FVC) characterizes chronic obstructive pulmonary disease (COPD) (1).COPD is currently the fourth leading cause of death in the United States and much of the developed world