Am. J. Respir. Crit. Care Med., Volume 164, Number 6, September 2001, 1008-1011

Elevated Plasma Fibrinogen Associated with Reduced Pulmonary Function and Increased Risk of Chronic Obstructive Pulmonary Disease

MORTEN DAHL, ANNE TYBJRG-HANSEN, JØRGEN VESTBO, PETER LANGE, and BØRGE G. NORDESTGAARD

Department of Clinical Biochemistry, Herlev and Copenhagen University Hospitals, Department of Respiratory Medicine, Hvidovre University Hospital; and The Copenhagen City Heart Study, Bispebjerg University Hospital, University of Copenhagen, Copenhagen, Denmark

We tested whether increased concentrations of the acute-phase reactant fibrinogen correlate with pulmonary function and rate of chronic obstructive pulmonary disease (COPD) hospitalization. We measured plasma fibrinogen and forced expiratory volume in 1 s (FEV₁), and assessed prospectively COPD hospitalizations in 8,955 adults from the Danish general population. Smokers with plasma fibrinogen in the upper and middle tertile (> 3.3 and 2.7-3.3 g/L) had 7% (95% confidence interval [CI]: 5-8%) and 2% (0-3%) lower percentage predicted FEV₁ than smokers with fibrinogen in the lower tertile (< 2.7 g/L). The equivalent decreases in nonsmokers were 6% (4-7%) and 0% (1-2%), respectively. Individuals with plasma fibrinogen in the upper and middle tertile had COPD hospitalization rates of 93 and 60 compared with 52 per 10,000 person-years in individuals with fibrinogen in the lower tertile (log-rank: p < 0.001 and p = 0.31). After adjusting for age, body mass index, sex, pack-years, and recent respiratory infections, relative risks for COPD hospitalization were 1.7 (95% CI: 1.1-2.6) and 1.4 (0.9-2.1) in individuals with fibrinogen in the upper and middle versus lower tertile. In conclusion, elevated plasma fibrinogen was associated with reduced FEV₁ and increased risk of COPD. This could not be explained by smoking alone.

Keywords: fibrinogen; pulmonary function; epidemiology; airway inflammation; COPD

This article has been cited by other articles:

				D. D. Sin and J. Vestbo Biomarkers in Chronic Obstructive Pulmonary Disease Proceedings of the ATS, September 15, 2009; 6(6): 543 - 545. [Abstract] [Full Text] [PDF]

				B. Thyagarajan, L. J. Smith, R. G. Barr, M. D. Gross, A. Sood, R. Kalhan, and D. R. Jacobs Jr Association of Circulating Adhesion Molecules With Lung Function: The CARDIA Study Chest, June 1, 2009; 135(6): 1481 - 1487. [Abstract] [Full Text] [PDF]

				P. J. Barnes and B. R. Celli Systemic manifestations and comorbidities of COPD Eur. Respir. J., May 1, 2009; 33(5): 1165 - 1185. [Abstract] [Full Text] [PDF]

				D R Taylor Risk assessment in asthma and COPD: a potential role for biomarkers? Thorax, March 1, 2009; 64(3): 261 - 264. [Abstract] [Full Text] [PDF]

				G Engstrom, N Segelstorm, M Ekberg-Aronsson, P M Nilsson, F Lindgarde, and C-G Lofdahl Plasma markers of inflammation and incidence of hospitalisations for COPD: results from a population-based cohort study Thorax, March 1, 2009; 64(3): 211 - 215. [Abstract] [Full Text] [PDF]

				D R Taylor and I D Pavord Biomarkers in the assessment and management of airways diseases Postgrad. Med. J., December 1, 2008; 84(998): 628 - 634. [Abstract] [Full Text] [PDF]

				R. Jiang, G. L. Burke, P. L. Enright, A. B. Newman, H. G. Margolis, M. Cushman, R. P. Tracy, Y. Wang, R. A. Kronmal, and R. G. Barr Inflammatory Markers and Longitudinal Lung Function Decline in the Elderly Am. J. Epidemiol., September 15, 2008; 168(6): 602 - 610. [Abstract] [Full Text] [PDF]

				J. Sunyer, R. Pistelli, E. Plana, M. Andreani, F. Baldari, M. Kolz, W. Koenig, J. Pekkanen, A. Peters, and F. Forastiere Systemic inflammation, genetic susceptibility and lung function Eur. Respir. J., July 1, 2008; 32(1): 92 - 97. [Abstract] [Full Text] [PDF]

				J. A. Falk, O. A. Minai, and Z. Mosenifar Inhaled and Systemic Corticosteroids in Chronic Obstructive Pulmonary Disease Proceedings of the ATS, May 1, 2008; 5(4): 506 - 512. [Abstract] [Full Text] [PDF]

				K. H. Groenewegen, D. S. Postma, W. C. J. Hop, P. L. M. L. Wielders, N. J. J. Schlosser, E. F. M. Wouters, and for the COSMIC Study Group Increased Systemic Inflammation Is a Risk Factor for COPD Exacerbations* Chest, February 1, 2008; 133(2): 350 - 357. [Abstract] [Full Text] [PDF]

				J. Vestbo Systemic inflammation and progression of COPD Thorax, June 1, 2007; 62(6): 469 - 470. [Full Text] [PDF]

				M. Dahl, J. Vestbo, P. Lange, S. E. Bojesen, A. Tybjaerg-Hansen, and B. G. Nordestgaard C-reactive Protein As a Predictor of Prognosis in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., February 1, 2007; 175(3): 250 - 255. [Abstract] [Full Text] [PDF]

				D. Aronson, I. Roterman, M. Yigla, A. Kerner, O. Avizohar, R. Sella, P. Bartha, Y. Levy, and W. Markiewicz Inverse Association between Pulmonary Function and C-Reactive Protein in Apparently Healthy Subjects Am. J. Respir. Crit. Care Med., September 15, 2006; 174(6): 626 - 632. [Abstract] [Full Text] [PDF]

				B. Thyagarajan, D. R Jacobs, G. G Apostol, L. J Smith, C. E Lewis, and O D. Williams Plasma fibrinogen and lung function: the CARDIA Study Int. J. Epidemiol., August 1, 2006; 35(4): 1001 - 1008. [Abstract] [Full Text] [PDF]

				D. D Sin and S. P. Man Commentary: Fuelling the fire--systemic inflammation and development of lung disease in the general community Int. J. Epidemiol., August 1, 2006; 35(4): 1008 - 1010. [Full Text] [PDF]

				J. Vestbo, E. Prescott, T. Almdal, M. Dahl, B. G. Nordestgaard, T. Andersen, T. I. A. Sorensen, and P. Lange Body Mass, Fat-Free Body Mass, and Prognosis in Patients with Chronic Obstructive Pulmonary Disease from a Random Population Sample: Findings from the Copenhagen City Heart Study Am. J. Respir. Crit. Care Med., January 1, 2006; 173(1): 79 - 83. [Abstract] [Full Text] [PDF]

				G. C. Donaldson, T. A. R. Seemungal, I. S. Patel, A. Bhowmik, T. M. A. Wilkinson, J. R. Hurst, P. K. MacCallum, and J. A. Wedzicha Airway and Systemic Inflammation and Decline in Lung Function in Patients With COPD Chest, October 1, 2005; 128(4): 1995 - 2004. [Abstract] [Full Text] [PDF]

				F L Fimognari, L Moro, R Antonelli Incalzi, D D Sin, W Q Gan, S F P Man, and A Senthilselvan COPD, restrictive syndrome and inflammation Thorax, July 1, 2005; 60(7): 612 - 613. [Full Text] [PDF]

				E. F. M. Wouters Local and Systemic Inflammation in Chronic Obstructive Pulmonary Disease Proceedings of the ATS, April 1, 2005; 2(1): 26 - 33. [Abstract] [Full Text] [PDF]

				P. K. MacCallum Markers of Hemostasis and Systemic Inflammation in Heart Disease and Atherosclerosis in Smokers Proceedings of the ATS, April 1, 2005; 2(1): 34 - 43. [Abstract] [Full Text] [PDF]

				S Kony, M Zureik, F Driss, C Neukirch, B Leynaert, and F Neukirch Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study Thorax, October 1, 2004; 59(10): 892 - 896. [Abstract] [Full Text] [PDF]

				W Q Gan, S F P Man, A Senthilselvan, and D D Sin Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis Thorax, July 1, 2004; 59(7): 574 - 580. [Abstract] [Full Text] [PDF]

				D M Mannino, F Holguin, H M Greves, A Savage-Brown, A L Stock, and R L Jones Urinary cadmium levels predict lower lung function in current and former smokers: data from the Third National Health and Nutrition Examination Survey Thorax, March 1, 2004; 59(3): 194 - 198. [Abstract] [Full Text] [PDF]

				The pharmacoepidemiology of COPD: Recent advances and methodological discussion Eur. Respir. J., September 1, 2003; 22(43_suppl): 1s - 44s. [Full Text] [PDF]

				B Sjogren, J Weiner, and K Larsson Ischaemic heart disease among livestock and agricultural workers Occup. Environ. Med., August 1, 2003; 60(8): e1 - 1. [Abstract] [Full Text] [PDF]

				R. E. Walter, A. Beiser, R. J. Givelber, G. T. O'Connor, and D. J. Gottlieb Association between Glycemic State and Lung Function: The Framingham Heart Study Am. J. Respir. Crit. Care Med., March 15, 2003; 167(6): 911 - 916. [Abstract] [Full Text] [PDF]

				A J White, S Gompertz, and R A Stockley Chronic obstructive pulmonary disease * 6: The aetiology of exacerbations of chronic obstructive pulmonary disease Thorax, January 1, 2003; 58(1): 73 - 80. [Abstract] [Full Text] [PDF]

				G. Engstrom, P. Lind, B. Hedblad, P. Wollmer, L. Stavenow, L. Janzon, and F. Lindgarde Lung Function and Cardiovascular Risk: Relationship With Inflammation-Sensitive Plasma Proteins Circulation, November 12, 2002; 106(20): 2555 - 2560. [Abstract] [Full Text] [PDF]

				M Kelly, M A Dentener, E C Creutzberg, and E F M Wouters Pathophysiology of COPD Thorax, June 1, 2002; 57(6): 563 - 564. [Full Text] [PDF]

				M. J. TOBIN Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2001 Am. J. Respir. Crit. Care Med., March 1, 2002; 165(5): 642 - 662. [Full Text] [PDF]