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CRP is associated with lung function decline in men but not women: a prospective study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Lungmedicin och allergologi)
Faculty of Medicine, University of Iceland; Department of Allergy, Respiratory Medicine & Sleep, Landspitali University Hospital.
Faculty of Medicine, University of Iceland; Icelandic Heart Association.
Faculty of Medicine, University of Iceland; Department of Allergy, Respiratory Medicine & Sleep, Landspitali University Hospital.
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2013 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 107, no 1, 91-97 p.Article in journal (Refereed) Published
Abstract [en]

Systemic inflammation is associated with impaired lung function. Studies, most cross-sectional, report a stronger association between systemic inflammation and lung function impairment in men than women. The aim was to evaluate gender differences in the longitudinal association between systemic inflammation and lung function.

We used data from randomly chosen residents of Reykjavík, born 1940–54, who were investigated in three stages: Baseline (1973–75; 1983–85) and follow-up (2001–03). The participants (n = 1049, 574 women) had a mean age of 28 ± 6 years at baseline and mean follow-up time of 27 ± 4 years. At each stage lung function (FEV1 and FVC) and C-reactive protein (CRP) were evaluated.

Change in FEV1 (p = 0.04) and FVC (p = 0.01) was associated with baseline CRP in men but not in women. In the multiple variable analysis, CRP at baseline was associated with a decline in FEV1 (−3.1 mL/year, 95% CI: −5.1, −0.99) and FVC (−2.5 mL/year, 95% CI: −4.4, −0.65) in men but not in women. Similarly during follow-up, change in CRP, standardised to 1SD, was associated with a decline in FEV1 (−0.19 mL/year, 95% CI: −0.30, −0.07) and FVC (−0.11 mL/year, 95% CI: −0.22, −0.01)) in men but not in women.

This prospective study confirms a stronger association between systemic inflammation and lung function decline in men than in women. This may indicate a gender difference in the mechanisms of lung function decline.

Place, publisher, year, edition, pages
2013. Vol. 107, no 1, 91-97 p.
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-160224DOI: 10.1016/j.rmed.2012.09.020ISI: 000314135600011OAI: oai:DiVA.org:uu-160224DiVA: diva2:448743
Available from: 2011-10-18 Created: 2011-10-18 Last updated: 2017-12-08Bibliographically 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)
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Available from: 2011-11-02 Created: 2011-10-18 Last updated: 2011-11-10Bibliographically approved

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Olafsdottir, Inga SifJanson, Christer

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