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Gender differences in the association between C-reactive protein, lung function impairment, and COPD
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Lungmedicin och allergologi)
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2007 (English)In: International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, Vol. 2, no 4, 635-642 p.Article in journal (Refereed) Published
Abstract [en]

Individuals with COPD have systemic inflammation that can be assessed by measuring C-reactive protein (CRP). In this paper we evaluated whether CRP is related to COPD, lung function and rate of lung function decline. We included 1237 randomly selected subjects (mean age 42, range 28–56 years) from three centers in the European Community Respiratory Health Survey: Reykjavik, Uppsala and Tartu. CRP was measured at the end of the follow-up (mean 8.3 years) and the values were divided into 4 quartiles. Fifty-three non-asthmatic subjects fulfilled spirometric criteria for COPD (FEV1/FVC < 70%). COPD occurred more often in the 4th CRP quartile (OR (95% CI) 3.21 (1.13–9.08)) after adjustment for age, gender, body weight and smoking. High CRP levels were related to lower FEV1 values in both men (−437 (−596, −279) mL) and women (−144 (−243, −44) mL). The negative association between CRP and FEV1 was significantly larger in men than women (p = 0.04). The decline in FEV1 was larger (16 (5, 27) mL) in men with high CRP levels whereas no significant association between CRP and FEV1 decline was found in women. Higher CRP values are significantly associated with COPD and lower lung function in men and women. In men higher CRP values are related to a larger decline in FEV1.

Place, publisher, year, edition, pages
2007. Vol. 2, no 4, 635-642 p.
Keyword [en]
Adult, C-Reactive Protein/analysis/immunology/*metabolism, Estonia, Female, Humans, Iceland, Male, Middle Aged, Pulmonary Disease; Chronic Obstructive/*immunology, Questionnaires, Respiratory Function Tests, Respiratory Insufficiency/*immunology, Sex Factors, Smoking/immunology, Spirometry, Sweden
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-16771PubMedID: 18268938OAI: oai:DiVA.org:uu-16771DiVA: diva2:44542
Available from: 2008-06-04 Created: 2008-06-04 Last updated: 2012-02-29Bibliographically approved
In thesis
1. Inflammatory Markers, Respiratory Diseases, Lung Function and Associated Gender Differences
Open this publication in new window or tab >>Inflammatory Markers, Respiratory Diseases, Lung Function and Associated Gender Differences
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Systemic inflammation is associated with impaired lung function. Inflammation is part of asthma and chronic obstructive pulmonary disease (COPD), but the local and systemic inflammatory pattern differs.

The overall aim was to evaluate systemic inflammatory markers in obstructive lung diseases and more specifically: To determine if CRP is related to respiratory symptoms, asthma, atopy and bronchial responsiveness (paper I), in a population sample from three countries (paper I and II); to evaluate if CRP is related to COPD, lung function and rate of lung function decline (paper II); to investigate the association of serum MMP-9 and TIMP-1 with lung function in a cross-sectional population based study (paper III); and finally, to study possible gender differences in the longitudinal association between CRP and lung function in a prospective population based study (paper IV).

In the first study we reported that CRP was related to non-allergic asthma but not allergic asthma, and that CRP was related to respiratory symptoms such as wheeze, nocturnal cough and breathlessness after effort, but not associated with atopy or bronchial responsiveness.

In the second study we found that COPD was more common in subjects in the highest CRP quartiles and higher CRP levels were associated with lower FEV1 values in both men and women, but the negative association between CRP and FEV1 was larger in men than women. The FEV1 decline was larger in men with high CRP levels, whereas no such association was found for women.

In the third study we reported that lower FEV1 was associated with higher levels of MMP-9, TIMP-1 and their ratio MMP-9/TIMP-1. After stratification for gender this association was significant in men but not women.

In the fourth study we found that CRP levels were associated with change in both FEV1 and FVC in men but not women. This association was found for both baseline CRP and change in CRP, confirming a stronger association between systemic inflammation and lung function decline in men than women.

In conclusion, systemic inflammation is associated with non-allergic asthma but not allergic asthma. Our findings of a stronger association between the systemic inflammation and lung function impairment in men, but not women, may indicate a gender difference in the mechanisms of lung function decline.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 64 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 714
Keyword
C-reactive protein, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1, COPD, FEV1, FVC, lung function, systemic inflammation, gender differences
National Category
Respiratory Medicine and Allergy
Research subject
Lung Medicine
Identifiers
urn:nbn:se:uu:diva-160226 (URN)978-91-554-8194-0 (ISBN)
Public defence
2011-11-25, Enghoffssalen, 50 huset, Akademiska University Hospital, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2011-11-02 Created: 2011-10-18 Last updated: 2011-11-10Bibliographically approved

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Olafsdottir, Inga SifJõgi, RainJanson, Christer

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