Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023;102(3):194-202.
doi: 10.1159/000529031. Epub 2023 Jan 23.

Centrilobular Emphysema Is Associated with Pectoralis Muscle Reduction in Current Smokers without Airflow Limitation

Tomoki Maetani  1 , Naoya Tanabe  1 , Yusuke Shiraishi  1 , Takafumi Shimada  2 , Satoru Terada  1 , Hiroshi Shima  1 , Fumi Mochizuki  2 , Ryo Sakamoto  3 , Shizuo Kaji  4 , Tsuyoshi Oguma  1 , Susumu Sato  1   5 , Hiroaki Iijima  2 , Izuru Masuda  6 , Toyohiro Hirai  1
Affiliations

Centrilobular Emphysema Is Associated with Pectoralis Muscle Reduction in Current Smokers without Airflow Limitation

Tomoki Maetani et al. Respiration. 2023.

Abstract

Background: Physiological and prognostic associations of centrilobular emphysema (CLE) and paraseptal emphysema (PSE) in smokers with and without chronic obstructive pulmonary disease (COPD) have been increasingly recognized, but the associations with extrapulmonary abnormalities, such as muscle wasting, osteoporosis, and cardiovascular diseases, remain unestablished.

Objectives: The aim of the study was to investigate whether CLE was associated with extrapulmonary abnormalities independent of concomitant PSE in smokers without airflow limitation.

Methods: This retrospective study consecutively enrolled current smokers without airflow limitation who underwent lung cancer screening with computed tomography and spirometry. CLE and PSE were visually identified based on the Fleischner Society classification system. Cross-sectional areas of pectoralis muscles (PM) and adjacent subcutaneous adipose tissue (SAT), bone mineral density (BMD), and coronary artery calcification (CAC) were evaluated.

Results: Of 310 current smokers without airflow limitation, 83 (26.8%) had CLE. The PSE prevalence was higher (67.5% vs. 23.3%), and PM area, SAT area, and BMD were lower in smokers with CLE than in those without (PM area (mean), 34.5 versus 38.6 cm2; SAT area (mean), 29.3 versus 36.8 cm2; BMD (mean), 158.3 versus 178.4 Hounsfield unit), while CAC presence did not differ. In multivariable models, CLE was associated with lower PM area but not with SAT area or BMD, after adjusting for PSE presence, demographics, and forced expiratory volume in 1 s.

Conclusions: The observed association between CLE and lower PM area suggests that susceptibility to skeletal muscle loss could be high in smokers with CLE even without COPD.

Keywords: Chest computed tomography; Chronic obstructive pulmonary disease; Emphysema; Muscle wasting.

PubMed Disclaimer

Conflict of interest statement

Naoya Tanabe, Susumu Sato, Tsuyoshi Oguma, and Toyohiro Hirai were supported by a grant from FUJIFILM Co., Ltd. Susumu Sato received grants from Nippon Boehringer Ingelheim, Philips Respironics, Fukuda Denshi, Fukuda Lifetec Keiji, and ResMed outside of the submitted work. None of these companies played a role in the design or analysis of the study or in the writing of the manuscript. The other authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Prevalence of centrilobular emphysema (CLE) and paraseptal emphysema (PSE). a Evaluation of CLE. The bar graph illustrates the proportions of CLE classifications (trace: 16.1%, mild: 9.4%, moderate: 1.0%, advanced destructive: 0.3%). Moderate and advanced destructive emphysema were categorized as “severe”. b Evaluation of PSE. The proportion of PSE is depicted, divided by the presence of CLE.
Fig. 2
Fig. 2
Comparisons of extrapulmonary CT measures between smokers with and without centrilobular emphysema (CLE). a Illustration of extrapulmonary structures, including the pectoralis muscles (PM, red), subcutaneous adipose tissue adjacent to the PM (SAT, blue), erector spinae muscles (ESM, green), and epicardial adipose tissue (EAT, magenta), coronary artery calcification (CAC, yellow), and bone marrow density (BMD, cyan) on chest CT. b PM area and SAT area were significantly lower in smokers with CLE than in those without CLE. In statistical analyses, SAT was log2-transformed. c BMD was significantly lower in smokers with CLE than in those without CLE. d The rate of CAC did not differ between smokers with and without CLE. e Height-adjusted cross-sectional areas of PM, SAT, ESM, and EAT (PM index, SAT index, ESM index, and EAT index) were also compared between smokers with and without CLE. In statistical analyses, SAT index was log2-transformed. * indicates p < 0.05 compared to smokers without CLE.
See this image and copyright information in PMC

References

    1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010 a systematic analysis for the global burden of disease Study 2010. Lancet. 2012;380((9859)):2224–2260. - PMC - PubMed
    1. Banks E, Joshy G, Weber MF, Liu B, Grenfell R, Egger S, et al. Tobacco smoking and all-cause mortality in a large Australian cohort study findings from a mature epidemic with current low smoking prevalence. BMC Med. 2015 Feb 24;13((1)):38. - PMC - PubMed
    1. Schaap LA, Pluijm SMF, Deeg DJH, Visser M. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med. 2006 Jun;119((6)):526.e9–617.e9. - PubMed
    1. Yanbaeva DG, Dentener MA, Creutzberg EC, Wesseling G, Wouters EFM. Systemic effects of smoking. Chest. 2007 May;131((5)):1557–1566. - PubMed
    1. Rabe KF, Watz H. Chronic obstructive pulmonary disease. Lancet. 2017;389((10082)):1931–1940. - PubMed

MeSH terms