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Are Systemic Manifestations Ascribable to COPD in Smokers? A Structural Equation Modeling Approach.
Boyer, Laurent; Bastuji-Garin, Sylvie; Chouaid, Christos; Housset, Bruno; Le Corvoisier, Philippe; Derumeaux, Geneviève; Boczkowski, Jorge; Maitre, Bernard; Adnot, Serge; Audureau, Etienne.
Afiliación
  • Boyer L; APHP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, DHU A-TVB, F-94010, Créteil, France.
  • Bastuji-Garin S; INSERM U955 and Université Paris Est (UPEC), UMR U955, Faculté de médecine, Créteil, F-94010, France.
  • Chouaid C; APHP, Hôpital Henri Mondor, Département de Santé Publique, F-94010, Créteil, France.
  • Housset B; Université Paris Est (UPEC), Faculté de médecine, CEpiA, EA7376, Créteil, F-94010, France.
  • Le Corvoisier P; Centre Hospitalier Intercommunal, Département de Pneumologie et Pathologie Professionnelle, Créteil, F-94000, France.
  • Derumeaux G; Centre Hospitalier Intercommunal, Département de Pneumologie et Pathologie Professionnelle, Créteil, F-94000, France.
  • Boczkowski J; Inserm, Centre d'Investigation Clinique 1430, and APHP, Hôpital Henri Mondor, F-94010, Créteil, France.
  • Maitre B; APHP, Hôpital Henri Mondor, Département de Physiologie-Explorations Fonctionnelles, DHU A-TVB, F-94010, Créteil, France.
  • Adnot S; INSERM U955 and Université Paris Est (UPEC), UMR U955, Faculté de médecine, Créteil, F-94010, France.
  • Audureau E; INSERM U955 and Université Paris Est (UPEC), UMR U955, Faculté de médecine, Créteil, F-94010, France.
Sci Rep ; 8(1): 8569, 2018 06 05.
Article en En | MEDLINE | ID: mdl-29872127
Whether the systemic manifestations observed in Chronic Obstructive Pulmonary Disease (COPD) are ascribable to lung dysfunction or direct effects of smoking is in debate. Structural Equations Modeling (SEM), a causal-oriented statistical approach, could help unraveling the pathways involved, by enabling estimation of direct and indirect associations between variables. The objectives of the study was to investigate the relative impact of smoking and COPD on systemic manifestations, inflammation and telomere length. In 292 individuals (103 women; 97 smokers with COPD, 96 smokers without COPD, 99 non-smokers), we used SEM to explore the pathways between smoking (pack-years), lung disease (FEV1, KCO), and the following parameters: arterial stiffness (aortic pulse wave velocity, PWV), bone mineral density (BMD), appendicular skeletal muscle mass (ASMM), grip strength, insulin resistance (HOMA-IR), creatinine clearance (eGFR), blood leukocyte telomere length and inflammatory markers (Luminex assay). All models were adjusted on age and gender. Latent variables were created for systemic inflammation (inflammatory markers) and musculoskeletal parameters (ASMM, grip strength, BMD). SEM showed that most effects of smoking were indirectly mediated by lung dysfunction: e.g. via FEV1 on musculoskeletal factor, eGFR, HOMA-IR, PWV, telomere length, CRP, white blood cells count (WBC) and inflammation factor, and via KCO on musculoskeletal factor, eGFR and PWV. Direct effects of smoking were limited to CRP and WBC. Models had excellent fit. In conclusion, SEM highlighted the major role of COPD in the occurrence of systemic manifestations while smoking effects were mostly mediated by lung function.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Pulmonar Obstructiva Crónica / Fumadores / No Fumadores Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Sci Rep Año: 2018 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Pulmonar Obstructiva Crónica / Fumadores / No Fumadores Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Sci Rep Año: 2018 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido