Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease: The Multi-Ethnic Study of Atherosclerosis (MESA)–Lung Study

David J Lederer; Paul L Enright; Steven M Kawut; Eric A Hoffman; Gary Hunninghake; Edwin J. R van Beek; John H. M Austin; Rui Jiang; Gina S Lovasi; R. Graham Barr

doi:10.1164/rccm.200812-1966OC

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Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease: The Multi-Ethnic Study of Atherosclerosis (MESA)–Lung Study

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Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease: The Multi-Ethnic Study of Atherosclerosis (MESA)–Lung Study

David J Lederer, Paul L Enright, Steven M Kawut, Eric A Hoffman, Gary Hunninghake, Edwin J. R van Beek, John H. M Austin, Rui Jiang, Gina S Lovasi and R. Graham Barr

American journal of respiratory and critical care medicine, Vol.180(5), pp.407-414

09/01/2009

DOI: 10.1164/rccm.200812-1966OC

PMCID: PMC2742759

PMID: 19542480

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Abstract

Rationale : Cigarette smoking is a risk factor for diffuse 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.

Computed Tomography

cigarette smoking

restrictive lung disease

spirometry

interstitial lung disease

B. Chronic Obstructive Pulmonary Disease

Details

Title: Subtitle: Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease: The Multi-Ethnic Study of Atherosclerosis (MESA)–Lung Study
Creators: David J Lederer - Department of Medicine, and
Paul L Enright - Department of Medicine, and
Steven M Kawut - Department of Medicine, and
Eric A Hoffman - Department of Medicine, and
Gary Hunninghake - Department of Medicine, and
Edwin J. R van Beek - Department of Medicine, and
John H. M Austin - Department of Medicine, and
Rui Jiang - Department of Medicine, and
Gina S Lovasi - Department of Medicine, and
R. Graham Barr - Department of Medicine, and
Resource Type: Journal article
Publication Details: American journal of respiratory and critical care medicine, Vol.180(5), pp.407-414
DOI: 10.1164/rccm.200812-1966OC
PMID: 19542480
PMCID: PMC2742759
NLM abbreviation: Am J Respir Crit Care Med
ISSN: 1073-449X
eISSN: 1535-4970
Publisher: American Thoracic Society
Language: English
Date published: 09/01/2009
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051567002771

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