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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Hatabu, Hiroto Nishino, Mizuki Silverman, Edwin K. Khorasani, Ramin Sciurba, Frank C. Andriole, Katherine P. Rosas, Ivan O. Hunninghake, Gary M. Okajima, Yuka Yamashiro, Tsuneo Ross, James C. Fernandez, Isis E. Estépar, Raúl San José Lynch, David A. D'aco, Katherine Washko, George R. Brehm, John M. Diaz, Alejandro A. |
| Description | Author Affiliation: Washko GR ( Pulmonary and Critical Care Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.) |
| Abstract | BACKGROUND: Cigarette smoking is associated with emphysema and radiographic interstitial lung abnormalities. The degree to which interstitial lung abnormalities are associated with reduced total lung capacity and the extent of emphysema is not known. METHODS: We looked for interstitial lung abnormalities in 2416 (96%) of 2508 high-resolution computed tomographic (HRCT) scans of the lung obtained from a cohort of smokers. We used linear and logistic regression to evaluate the associations between interstitial lung abnormalities and HRCT measurements of total lung capacity and emphysema. RESULTS: Interstitial lung abnormalities were present in 194 (8%) of the 2416 HRCT scans evaluated. In statistical models adjusting for relevant covariates, interstitial lung abnormalities were associated with reduced total lung capacity (-0.444 liters; 95% confidence interval [CI], -0.596 to -0.292; P<0.001) and a lower percentage of emphysema defined by lung-attenuation thresholds of -950 Hounsfield units (-3%; 95% CI, -4 to -2; P<0.001) and -910 Hounsfield units (-10%; 95% CI, -12 to -8; P<0.001). As compared with participants without interstitial lung abnormalities, those with abnormalities were more likely to have a restrictive lung deficit (total lung capacity <80% of the predicted value; odds ratio, 2.3; 95% CI, 1.4 to 3.7; P<0.001) and were less likely to meet the diagnostic criteria for chronic obstructive pulmonary disease (COPD) (odds ratio, 0.53; 95% CI, 0.37 to 0.76; P<0.001). The effect of interstitial lung abnormalities on total lung capacity and emphysema was dependent on COPD status (P<0.02 for the interactions). Interstitial lung abnormalities were positively associated with both greater exposure to tobacco smoke and current smoking. CONCLUSIONS: In smokers, interstitial lung abnormalities--which were present on about 1 of every 12 HRCT scans--were associated with reduced total lung capacity and a lesser amount of emphysema. (Funded by the National Institutes of Health and the Parker B. Francis Foundation; ClinicalTrials.gov number, NCT00608764.). |
| ISSN | 00284793 |
| e-ISSN | 15334406 |
| Journal | New England Journal of Medicine |
| Issue Number | 10 |
| Volume Number | 364 |
| Language | English |
| Publisher | Massachusetts Medical Society (United States) |
| Publisher Date | 2011-03-10 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Lung Diseases, Interstitial Pathology Lung Pulmonary Disease, Chronic Obstructive Pulmonary Emphysema Smoking Total Lung Capacity Cohort Studies Linear Models Logistic Models Etiology Pulmonary Fibrosis Adverse Effects Spirometry Tomography, X-Ray Computed Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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