Cholesterol, lipoproteins and subclinical interstitial lung disease: the MESA study

Abstract

We investigated associations of plasma lipoproteins with subclinical interstitial lung disease (ILD) by measuring high attenuation areas (HAA: lung voxels between -600 and -250 Hounsfield units) in 6700 adults and serum MMP-7 and SP-A in 1216 adults age 45-84 without clinical cardiovascular disease in Multi-Ethnic Study of Atherosclerosis. In cross-sectional analyses, each SD decrement in high density lipoprotein cholesterol (HDL-C) was associated with a 2.12% HAA increment (95% CI 1.44% to 2.79%), a 3.53% MMP-7 increment (95% CI 0.93% to 6.07%) and a 6.37% SP-A increment (95% CI 1.35% to 11.13%), independent of demographics, smoking and inflammatory biomarkers. These findings support a novel hypothesis that HDL-C might influence subclinical lung injury and extracellular matrix remodelling.

Keywords: Clinical Epidemiology; Idiopathic pulmonary fibrosis; Imaging/CT MRI etc; Interstitial Fibrosis.

Figure 1

Continuous association between HDL-C and HAA adjusted for age, gender, race/ethnicity, educational attainment, height, body mass index, waist circumference, smoking status, cigarette pack-years, presence of hypertension, presence of diabetes, low density lipoprotein,, triglycerides, c-reactive protein, interleukin-6, glomerular filtration rate, statin use, diuretic use, coronary artery calcium, study site, milliAmpere dose, total volume imaged lung, percent emphysema on CT, left ventricular ejection fraction and left ventricular end-diastolic mass; p for nonlinearity 0.009, p for association <0.001. Dark dotted line is the continuous association. Thin solid lines are the 95% confidence bands. Each point in the graph and each vertical hashmark in the rug plot along the x-axis represent one study participant.