Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease The Multi-Ethnic Study of Atherosclerosis (MESA)-Lung Study
Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease The Multi-Ethnic Study of Atherosclerosis (MESA)-Lung Study
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DOI：
10.1164/rccm.200812-1966oc
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发表时间：
2009-09-01
影响因子：
24.7
通讯作者：
Barr, R. Graham
中科院分区：
文献类型：
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作者：
Lederer, David J.;Enright, Paul L.;Barr, R. Graham
基本原理：吸烟是患悬崖肺病的一个危险因素。亚临床实质性肺病的危险因素尚未被描述。目的：确定吸烟是否与亚临床实质性肺部疾病有关，通过肺功能限制和CT成像的高密度区域来测量。方法：我们在动脉粥样硬化的多种族研究中调查了2563名没有气流障碍或临床心血管疾病的成年人，这是一个来自美国6个社区的基于人群的队列。累积吸烟量和当前吸烟量分别通过包装年限和尿可替宁进行评估。肺活量受限被定义为用力肺活量小于正常下限。心脏CT扫描的肺野高密度区被定义为衰减在-600至-250 Hounsfield单位之间的区域，反映磨玻璃和网状结构的异常。采用广义加性模型对年龄、性别、种族/民族、吸烟状况、人体测量学、中心和CT扫描参数进行调整。测量和主要结果：在多因素分析中，肺活量受限的患病率为10.0%(95%可信区间[CI]，8.9-11.2%)，每10包香烟年相对增加8%(95%可信区间，3-12%)。高密度区体积中位数为119 cm(3)，四分位数范围为100~143 cm(3)。多因素分析显示，吸烟每10年高密度区体积增加1.6 cm(3)(95%CI，0.9~2.4 cm(3))。结论：吸烟可引起亚临床肺实质疾病，即使在一般健康人群中，吸烟也可通过肺活量测定和CT成像发现。
Rationale: Cigarette smoking is a risk factor for Cliff use parenchymal lung disease. Risk factors for subclinical parenchymal lung disease have not been described.Objectives: To determine if cigarette smoking is associated with subclinical parenchymal lung disease, as measured by spirometric restriction and regions of high attenuation on computed tomography (CT) imaging.Methods: We examined 2,563 adults without airflow obstruction or clinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis, a population-based cohort sampled from six communities in the United States. Cumulative and current cigarette smoking were assessed by pack-years and urine cotinine, respectively. Spirometric restriction was defined as a forced vital capacity less than the lower limit of normal. High attenuation areas on the lung fields of cardiac CT scans were defined as regions having an attenuation between -600 and -250 Hounsfield units, reflecting ground-glass and reticular abnormalities. Generalized additive models were used to adjust for age, gender, race/ethnicity, smoking status, anthropometrics, center, and CT scan parameters.Measurements and Main Results: The prevalence of spirometric restriction was 10.0% (95% confidence interval [CI], 8.9-11.2%) and increased relatively by 8% (95% CI, 3-12%) for each 10 cigarette pack-years in multivariate analysis. The median volume of high attenuation areas was 119 cm(3) (interquartile range, 100-143 cm(3)). The volume of high attenuation areas increased by 1.6 cm(3) (95% CI, 0.9-2.4 cm(3)) for each 10 cigarette pack-years in multivariate analysis.Conclusions: Smoking may cause subclinical parenchymal lung disease detectable by spirometry and CT imaging, even among a generally healthy cohort.