Published ahead of print on June 15, 2006, doi:10.1164/rccm.200602-243OC
Am. J. Respir. Crit. Care Med., Volume 174, Number 6, September 2006, 626-632
A more recent version of this article appeared on September 15, 2006
Submitted on February 19, 2006
Accepted on June 9, 2006
Inverse Association Between Pulmonary Function and C-reactive Protein in Apparently Healthy Subjects
Doron Aronson1*, Inon Roterman1, Mordechay Yigla2, Arthur Kerner1, Ophir Avizohar3, Ron Sella1, Peter Bartha4, Yishai Levy4, and Walter Markiewicz1
1 Department of Cardiology, Rambam Medical Center and Rappaport Faculty of Medicine, Haifa, Israel,
2 Department of Pulmonology, Rambam Medical Center and Rappaport Faculty of Medicine, Haifa, Israel,
3 Center for Preventive Medicine, Rambam Medical Center and Rappaport Faculty of Medicine, Haifa, Israel,
4 Internal Medicine D, Rambam Medical Center and Rappaport Faculty of Medicine, Haifa, Israel
* To whom correspondence should be addressed. E-mail: daronson{at}techunix.technion.ac.il.
Rationale: Increased levels of systemic markers of inflammation have been reported in patients with impaired lung function due to obstructive or restrictive lung disease.
Objective: We tested the hypothesis that a decline in lung function within the normal range may be associated with a systemic subclinical inflammation.
Methods: Pulmonary function tests, cardiorespiratory fitness, components of the metabolic syndrome, and high-sensitivity C-reactive protein were determined in 1131 subjects without known pulmonary disease.
Measurements and main results: Ninety-six of the study participants (8.5%) had forced expiratory volume in 1 second of less than 80% of predicted values. There was a strong inverse association between C-reactive protein levels and quartiles of forced expiratory volume in 1 second. Median C-reactive protein level in nonsmoking participants was 2.5, 1.8, 1.7, and 1.3 mg/L in the first, second, third and forth forced expiratory volume in 1-second quartile, respectively (P < 0.0001). Similar inverse association was present in smoking subjects (median C-reactive protein were 3.8, 2.3, 2.0, and 1.9 mg/L in the first, second, third and forth forced expiratory volume in 1 second quartile, respectively; P < 0.0001). These associations remained highly significant after adjustment for age, gender, components of the metabolic syndrome and fitness level (P = 0.0005).
Conclusions: An inverse linear relationship exists between CRP concentrations and measures of pulmonary function in subjects without pulmonary disease and in never-smokers. These results indicate that systemic inflammation may be linked to early perturbations of pulmonary function.
Key words: C-reactive protein; Forced vital capacity; Systemic inflammation; Obesity; Physical fitness
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