Inflammatory Markers and Longitudinal Lung Function Decline in the Elderly

• Published in: American journal of epidemiology Vol. 168; no. 6; pp. 602 - 610
• Main Authors: Jiang, Rui, Burke, Gregory L., Enright, Paul L., Newman, Anne B., Margolis, Helene G., Cushman, Mary, Tracy, Russell P., Wang, Yuanjia, Kronmal, Richard A., Barr, R. Graham
• Format: Journal Article
• Language: English
• Published: Cary, NC Oxford University Press 15.09.2008; Oxford Publishing Limited (England)
• Subjects: Aged; Analysis. Health state; Biological and medical sciences; biological markers; C-reactive protein; C-Reactive Protein - metabolism; Cross-Sectional Studies; Epidemiology; Female; fibrinogen; Fibrinogen - metabolism; Forced Expiratory Volume; General aspects; Geriatric Assessment - methods; Humans; inflammation; Inflammatory diseases; Investigative techniques of respiratory function; Investigative techniques, diagnostic techniques (general aspects); Logistic Models; Longitudinal Studies; Lung Volume Measurements; Male; Medical sciences; Multicenter Studies as Topic; Older people; Original Contributions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Pulmonary Disease, Chronic Obstructive - metabolism; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiration; Spirometry; vital capacity; C-reactive protein; spirometry; vital capacity; fibrinogen; inflammation; aged; biological markers; forced expiratory volume; Human; Spirometry; Biological marker; Exploration; Inflammation; Epidemiology; Acute phase protein; Lung function; Volume; Fibrinogen; C reactive protein; Elderly
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwn174

Longitudinal studies examining associations of the inflammatory markers fibrinogen and C-reactive protein (CRP) with lung function decline are sparse. The authors examined whether elevated fibrinogen and CRP levels were associated with greater longitudinal lung function decline in the elderly. The Cardiovascular Health Study measured fibrinogen and CRP in 5,790 Whites and African Americans from four US communities aged 65 years or older in 1989–1990 or 1992–1993. Spirometry was performed in 1989–1990 and 4, 7, and 16 years later. Fibrinogen and CRP were inversely associated with lung function at baseline after adjustment for multiple potential confounders. In mixed models, the rate of decline in forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio with increasing age was faster among those with higher baseline fibrinogen (−0.032%/year per standard deviation higher fibrinogen (95% confidence interval: −0.057, −0.0074)) but not among those with higher CRP (−0.0037%/year per standard deviation higher CRP (95% confidence interval: −0.013, 0.0056)). Longitudinal analyses for FEV1 and FVC yielded results in the direction opposite of that hypothesized, possibly because of the high mortality rate and strong inverse association of FEV1 and FVC but not FEV1/FVC with mortality. An alternative approach to missing data yielded similar results. In conclusion, higher levels of fibrinogen, but not CRP, independently predicted greater FEV1/FVC decline in the elderly.