Pectoralis muscle area and mortality in smokers without airflow obstruction.
Pectoralis muscle area and mortality in smokers without airflow obstruction.
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DOI：
10.1186/s12931-018-0771-6
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发表时间：
2018-04-10
影响因子：
5.8
通讯作者：
Washko GR
中科院分区：
文献类型：
--
作者：
Diaz AA;Martinez CH;Harmouche R;Young TP;McDonald ML;Ross JC;Han ML;Bowler R;Make B;Regan EA;Silverman EK;Crapo J;Boriek AM;Kinney GL;Hokanson JE;Estepar RSJ;Washko GR
在普通人群中，低肌肉质量与死亡率的增加有关，但它在无呼气气流障碍的高危吸烟者中的预后价值尚不清楚。我们的目的是验证这一假设，即肌肉质量减少与高危吸烟者死亡率增加有关。2008年至2013年，COPD基因研究对3705名45-80岁的现任和既往高危吸烟者(≥10包-年)进行了胸部CT扫描，测量了胸肌和椎旁竖脊肌横截面积(PMA和PVMA)以及肺气肿。通过死亡证明确认生命状况。用COX回归分析评估低肌肉质量与死亡率之间的关系。在中位数6.5年的随访中，212名(5.7%)高危吸烟者死亡。在人口统计学、吸烟、呼吸困难、合并症、运动量、肺功能、CT肺气肿和冠状动脉钙含量(危险比[HR]1.85，95%可信区间[1.14-3.00]P = 0.01)的调整模型中，高危吸烟者的死亡风险在最低(与最高)性别相关的四分位数中高84%。当使用PMA指数(PMA/Height2)代替四分位数时，结果是一致的。吸烟状况改变了PMA与死亡之间的关联(P = 0.04)。当前吸烟者的死亡风险显著增加(最低与最高PMA四分位数，HR2.25[1.25-4.03]P = 0.007)，而既往吸烟者没有。在没有气流阻塞的当前吸烟者中，胸部CT扫描测量的低肌肉质量与死亡率的增加有关。本文的在线版本(10.1186/s12931-0180771-6)包含可供授权用户使用的补充材料。
Low muscle mass is associated with increased mortality in the general population but its prognostic value in at-risk smokers, those without expiratory airflow obstruction, is unknown. We aimed to test the hypothesis that reduced muscle mass is associated with increased mortality in at-risk smokers. Measures of both pectoralis and paravertebral erector spinae muscle cross-sectional area (PMA and PVMA, respectively) as well as emphysema on chest computed tomography (CT) scans were performed in 3705 current and former at-risk smokers (≥10 pack-years) aged 45–80 years enrolled into the COPDGene Study between 2008 and 2013. Vital status was ascertained through death certificate. The association between low muscle mass and mortality was assessed using Cox regression analysis. During a median of 6.5 years of follow-up, 212 (5.7%) at-risk smokers died. At-risk smokers in the lowest (vs. highest) sex-specific quartile of PMA but not PVMA had 84% higher risk of death in adjusted models for demographics, smoking, dyspnea, comorbidities, exercise capacity, lung function, emphysema on CT, and coronary artery calcium content (hazard ratio [HR] 1.85 95% Confidence interval [1.14–3.00] P = 0.01). Results were consistent when the PMA index (PMA/height2) was used instead of quartiles. The association between PMA and death was modified by smoking status (P = 0.04). Current smokers had a significantly increased risk of death (lowest vs. highest PMA quartile, HR 2.25 [1.25–4.03] P = 0.007) while former smokers did not. Low muscle mass as measured on chest CT scans is associated with increased mortality in current smokers without airflow obstruction. NCT00608764 The online version of this article (10.1186/s12931-018-0771-6) contains supplementary material, which is available to authorized users.
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影响因子：
8.3
作者：
Martinez, Carlos H.;Murray, Susan;Han, MeiLan K.
通讯作者：
Han, MeiLan K.
影响因子：
4.7
作者：
Batsis, J. A.;Mackenzie, T. A.;Bartels, S. J.
通讯作者：
Bartels, S. J.
DOI：
10.1016/0735-1097(90)90282-t
发表时间：
1990-03-15
影响因子：
24
作者：
AGATSTON, AS;JANOWITZ, WR;DETRANO, R
通讯作者：
DETRANO, R
DOI：
10.1016/j.jamda.2011.07.004
发表时间：
2012-02-01
影响因子：
7.6
作者：
Landi, Francesco;Liperoti, Rosa;Onder, Graziano
通讯作者：
Onder, Graziano
影响因子：
37.8
作者：
McClelland, RL;Chung, HJ;Kronmal, RA
通讯作者：
Kronmal, RA