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Cobb K, Kenyon J, Lu J, Krieger B, Perelas A, Nana-Sinkam P, Kim Y, Rodriguez-Miguelez P. COPD is associated with increased cardiovascular disease risk independent of phenotype. Respirology 2024. [PMID: 39019777 DOI: 10.1111/resp.14799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide that frequently presents with concomitant cardiovascular diseases. Despite the pathological distinction between individual COPD phenotypes such as emphysema and chronic bronchitis, there is a lack of knowledge about the impact of COPD phenotype on cardiovascular disease risk. Thus, this study aimed to utilize a nationally representative sample to investigate cardiovascular disease prevalence in patients with COPD with emphysema and chronic bronchitis phenotypes. METHODS Data from 31,560 adults including 2504 individuals with COPD, collected as part of the National Health and Nutrition Examination Survey (1999-2018), were examined. RESULTS A significantly increased cardiovascular disease risk, including coronary heart disease, heart failure, myocardial infarction and stroke, was identified in patients with COPD among all disease phenotypes. Particularly, compared to those without COPD, individuals with chronic bronchitis presented with 1.76 (95% CI: 1.41-2.20) times greater odds, individuals with emphysema with 2.31 (95% CI: 1.80-2.96) times greater odds, while those with a concurrent phenotype (combined chronic bronchitis and emphysema) exhibited 2.98 (95% CI: 2.11-4.21) times greater odds of reporting cardiovascular diseases. CONCLUSION Our data confirms that patients with COPD present an elevated risk of developing cardiovascular disease among all phenotypes, with the most marked increase being in those with concurrent chronic bronchitis and emphysema phenotypes. These findings emphasize the need for awareness and appropriate cardiovascular screening in COPD.
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Affiliation(s)
- Kolton Cobb
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jonathan Kenyon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Juan Lu
- Division of Epidemiology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Benjamin Krieger
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Apostolos Perelas
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Patrick Nana-Sinkam
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Youngdeok Kim
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia, USA
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, Virginia, USA
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Cheng SL, Hedges M, Keski-Rahkonen P, Chatziioannou AC, Scalbert A, Chung KF, Sinharay R, Green DC, de Kok TMCM, Vlaanderen J, Kyrtopoulos SA, Kelly F, Portengen L, Vineis P, Vermeulen RCH, Chadeau-Hyam M, Dagnino S. Multiomic Signatures of Traffic-Related Air Pollution in London Reveal Potential Short-Term Perturbations in Gut Microbiome-Related Pathways. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:8771-8782. [PMID: 38728551 PMCID: PMC11112755 DOI: 10.1021/acs.est.3c09148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
This randomized crossover study investigated the metabolic and mRNA alterations associated with exposure to high and low traffic-related air pollution (TRAP) in 50 participants who were either healthy or were diagnosed with chronic pulmonary obstructive disease (COPD) or ischemic heart disease (IHD). For the first time, this study combined transcriptomics and serum metabolomics measured in the same participants over multiple time points (2 h before, and 2 and 24 h after exposure) and over two contrasted exposure regimes to identify potential multiomic modifications linked to TRAP exposure. With a multivariate normal model, we identified 78 metabolic features and 53 mRNA features associated with at least one TRAP exposure. Nitrogen dioxide (NO2) emerged as the dominant pollutant, with 67 unique associated metabolomic features. Pathway analysis and annotation of metabolic features consistently indicated perturbations in the tryptophan metabolism associated with NO2 exposure, particularly in the gut-microbiome-associated indole pathway. Conditional multiomics networks revealed complex and intricate mechanisms associated with TRAP exposure, with some effects persisting 24 h after exposure. Our findings indicate that exposure to TRAP can alter important physiological mechanisms even after a short-term exposure of a 2 h walk. We describe for the first time a potential link between NO2 exposure and perturbation of the microbiome-related pathways.
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Affiliation(s)
- Sibo Lucas Cheng
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
| | - Michael Hedges
- MRC
Centre for Environment and Health, Environmental Research Group, Imperial College London, London W12 0BZ, U.K.
| | | | | | - Augustin Scalbert
- International
Agency for Research on Cancer (IARC), Lyon 69366 Cedex, France
| | - Kian Fan Chung
- National
Heart & Lung Institute, Imperial College
London, London SW7 2AZ, U.K.
- Royal Brompton
& Harefield NHS Trust, London SW3 6NP, U.K.
| | - Rudy Sinharay
- National
Heart & Lung Institute, Imperial College
London, London SW7 2AZ, U.K.
- Imperial
College Healthcare NHS Trust, London W2 1NY, U.K.
| | - David C. Green
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Environmental Research Group, Imperial College London, London W12 0BZ, U.K.
| | - Theo M. C. M. de Kok
- Department
of Toxicogenomics, GROW School for Oncology and Reproduction, Maastricht University, Maastricht 6229 ER, The Netherlands
| | - Jelle Vlaanderen
- Division
of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht 3584 CS, The Netherlands
| | | | - Frank Kelly
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Environmental Research Group, Imperial College London, London W12 0BZ, U.K.
| | - Lützen Portengen
- Division
of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht 3584 CS, The Netherlands
| | - Paolo Vineis
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
| | - Roel C. H. Vermeulen
- Division
of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht 3584 CS, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University
Medical
Centre, Utrecht University, Utrecht 3584 CG, The Netherlands
| | - Marc Chadeau-Hyam
- NIHR
HPRU in Environmental Exposures and Health, Imperial College London, London W12 0BZ, U.K.
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
| | - Sonia Dagnino
- MRC
Centre for Environment and Health, Department of Epidemiology and
Biostatistics, School of Public Health, Imperial College London, London W12 7TA, U.K.
- Transporters
in Imaging and Radiotherapy in Oncology (TIRO), School
of Medicine, Direction de la Recherche Fondamentale (DRF), Institut
des Sciences du Vivant Fréderic Joliot, Commissariat à
l’Energie Atomique et aux Énergies Alternatives (CEA), Université Côte d’Azur (UniCA), Nice 06107, France
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3
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Lan Y, Ma Q, Luo G, Yang H, Li Y, Zhang Q. Epicardial adipose tissue in patients with chronic obstructive pulmonary disease: systematic review with meta‑analysis and trial sequential analysis. BMC Pulm Med 2023; 23:241. [PMID: 37400821 DOI: 10.1186/s12890-023-02535-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Limited data suggest that chronic obstructive pulmonary disease (COPD) patients have pathologic elevated epicardial adipose tissue (EAT), which is splanchnic fat tissue with anti-inflammatory properties and regulating free fatty acids functions. Therefore, there is a need for meta-analysis to explore the relationship between EAT and COPD. METHODS Online databases were systematically searched for studies about EAT in COPD patients published up to October 5th, 2022. The EAT data of the COPD patient group and the control group were included. Trial sequential analysis (TSA) and meta-analysis were applied to assess the difference in EAT between patients with and without COPD. TSA software and Stata 12.0 were used in all statistical analyses. RESULTS The final analysis included 5 studies (n = 596 patients). COPD patients had significantly more EAT than control subjects (SMD: 0.0.802; 95% CI: 0.231, 1.372; P = 0.006; TSA-adjusted 95% CI 1.20, 1.80; P < 0.0001). And higher CRP levels in COPD patients than non-COPD patients, whereas triglycerides and LDL were not significantly different between patients with and without COPD. CONCLUSION EAT is abnormally elevated in COPD patients, which may be related to systemic inflammatory responses in COPD. PROSPERO NUMBER CRD42021228273.
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Affiliation(s)
- Yi Lan
- Department of Pneumology, Songshan Hospital, Chongqing, China
| | - Qianli Ma
- Department of Pneumology, Songshan Hospital, Chongqing, China
| | - Guangming Luo
- Department of Pneumology, Songshan Hospital, Chongqing, China
| | - Heping Yang
- Department of Pneumology, Songshan Hospital, Chongqing, China
| | - Yingrui Li
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Qiao Zhang
- Department of Pneumology, Songshan Hospital, Chongqing, China.
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Zinellu A, Mangoni AA. The Emerging Clinical Significance of the Red Cell Distribution Width as a Biomarker in Chronic Obstructive Pulmonary Disease: A Systematic Review. J Clin Med 2022; 11:jcm11195642. [PMID: 36233510 PMCID: PMC9571455 DOI: 10.3390/jcm11195642] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
There is an intense focus on the identification of novel biomarkers of chronic obstructive pulmonary disease (COPD) to enhance clinical decisions in patients with stable disease and acute exacerbations (AECOPD). Though several local (airway) and circulatory inflammatory biomarkers have been proposed, emerging evidence also suggests a potential role for routine haematological parameters, e.g., the red cell distribution width (RDW). We conducted a systematic literature search in PubMed, Web of Science, and Scopus, from inception to April 2022, for articles investigating the diagnostic and prognostic role of the RDW in stable COPD and AECOPD. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Significant associations between the RDW and the presence and severity of disease, outcomes (mortality, hospital readmission), and other relevant clinical parameters (right heart failure, pulmonary arterial hypertension) were reported in 13 out of 16 studies in stable COPD (low risk of bias in 11 studies), and 17 out of 21 studies of AECOPD (low risk of bias in 11 studies). Pending further research, our systematic review suggests that the RDW might be useful, singly or in combination with other parameters, for the diagnosis and risk stratification of patients with stable COPD and AECOPD (PROSPERO registration number: CRD42022348304).
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
| | - Arduino A. Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, SA 5042, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Flinders Drive, Bedford Park, SA 5042, Australia
- Correspondence:
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