Serum Matrix Metalloproteinase-7, Respiratory Symptoms, and Mortality in Community-Dwelling Adults MESA (Multi-Ethnic Study of Atherosclerosis)
Serum Matrix Metalloproteinase-7, Respiratory Symptoms, and Mortality in Community-Dwelling Adults MESA (Multi-Ethnic Study of Atherosclerosis)
复制标题
社区成年人MESA的血清基质金属蛋白酶-7、呼吸道症状和死亡率(动脉粥样硬化的多种族研究)
DOI：
10.1164/rccm.201701-0254oc
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发表时间：
2017-11-15
影响因子：
24.7
通讯作者：
Lederer, David J.
中科院分区：
文献类型：
--
作者：
Armstrong, Hilary F.;Podolanczuk, Anna J.;Lederer, David J.
基本原理：基质金属蛋白酶-7（MMP-7）与间质性肺疾病的病理生物学有关，并被认为是特发性肺纤维化的诊断和预后生物标志物。目的：检测血清MMP-7与肺功能、呼吸系统症状、间质性肺异常（ILA）和全因死亡率之间的关系，并对社区居住的成年人进行采样，而不考虑呼吸系统症状或疾病。我们在基线时测量了梅萨（动脉粥样硬化多种族研究）中1，227名参与者的血清MMP-7。肺量测定（n = 697）、咳嗽（n = 722）和呼吸困难（n = 1,050）的5年结局数据可用。ILA（n = 561）和死亡率（n = 1，227）的10年结局数据可用。测量和主要结果：平均（6SD）血清MMP-7水平为4.3（+/-2.5）ng/ml（范围，1.2-24.1 ng/ml）。在校正模型中，血清MMP-7的每一个自然对数单位增量与FVC%的3.7%绝对下降相关。（95%置信区间[CI] = 0.9-6.6%），劳力性呼吸困难的几率增加1.6倍（95% CI = 1.3-1.9），ILA的几率增加1.5倍（95% CI = 1.1-2.1），全因死亡率增加2.2倍（95% CI = 1.9-2.5）。与ILA和死亡率之间的关联往往是更强的从不吸烟者（P值为0.06和0.01，分别）。结论：血清MMP-7水平可能是一个定量生物标志物的亚临床细胞外基质重塑在肺的社区居住的成年人，这可能有助于调查亚临床间质性肺疾病。
Rationale: Matrix metalloproteinase-7 (MMP-7) has been implicated in interstitial lung disease pathobiology and proposed as a diagnostic and prognostic biomarker of idiopathic pulmonary fibrosis.Objectives: To test associations between serum MMP-7 and lung function, respiratory symptoms, interstitial lung abnormalities (ILA), and all-cause mortality in community-dwelling adults sampled without regard to respiratory symptoms or disease.Methods: We measured serum MMP-7 in 1,227 participants in MESA (Multi-Ethnic Study of Atherosclerosis) at baseline. The 5-year outcome data were available for spirometry (n = 697), cough (n = 722), and dyspnea (n = 1,050). The 10-year outcome data were available for ILA (n = 561) and mortality (n = 1,227). We used linear, logistic, and Cox regression to control for potential confounders.Measurements and Main Results: The mean (6SD) serum MMP-7 level was 4.3 (+/- 2.5) ng/ml (range, 1.2-24.1 ng/ml). In adjusted models, each natural log unit increment in serum MMP-7 was associated with a 3.7% absolute decrement in FVC% (95% confidence interval [CI] = 0.9-6.6%), a 1.6-fold increased odds of exertional dyspnea (95% CI = 1.3-1.9), a 1.5-fold increased odds of ILAs (95% CI = 1.1-2.1), and a 2.2-fold increased all-cause mortality rate (95% CI = 1.9-2.5). The associations with ILA and mortality tended to be stronger among never-smokers (P values for interaction 0.06 and 0.01, respectively).Conclusions: SerumMMP-7 levels may be a quantitative biomarker of subclinical extracellular matrix remodeling in the lungs of community-dwelling adults, which may facilitate investigation of subclinical interstitial lung disease.