TY - JOUR
T1 - The relationship between interstitial lung abnormalities, mortality, and multimorbidity
T2 - A cohort study
AU - Sanders, Jason Leigh
AU - Axelsson, Gisli
AU - Putman, Rachel
AU - Menon, Aravind
AU - Dupuis, Josée
AU - Xu, Hanfei
AU - Wang, Shuai
AU - Murabito, Joanne
AU - Vasan, Ramachandran
AU - Araki, Tetsuro
AU - Nishino, Mizuki
AU - Washko, George R.
AU - Hatabu, Hiroto
AU - O'Connor, George
AU - Gudmundsson, Gunnar
AU - Gudnason, Vilmundur
AU - Hunninghake, Gary M.
N1 - Funding Information:
JLS is supported by the National Institutes of Health (NIH) grant T32 HL007633. RP is supported by NIH grant K08 HL140087. MN is supported by NIH grant R01 CA203636. GRW is supported by NIH grants U01 HL146408 and R01 HL122464. GO’ is supported by NIH grant OT2 OD026553. GG is supported by the Landspitali Scientific Fund A-2019-029 and 030, A-2020-017 and 018, University of Iceland Research Fund, and the Icelandic Research Fund project grant 141513-051 (to GG, VG, GMH). GA is supported by the Eimskip University Fund. VG is supported by National Institute on Aging grant 27120120022C. GMH and this work are supported by NIH grants R01 HL111024, R01135142, and R01130974. The Framingham Heart Study of the National Heart Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract Numbers N01-HC25195, HHSN268201500001 and 75N92019D00031. Additional support from 1R01 HL64753; R01 HL076784; 1R01 AG028321; 2R01 HL092577; 2U54HL120163; R01 AG031287 and R01 HL077477. The Age, Gene/Environment Susceptibility-Reykjavik Study was supported by NIH contracts N01-AG-1-2100 and HHSN27120120022C, the NIA Intramural Research Program, Hjartavernd (the Icelandic Heart Association) and the Althingi (the Icelandic Parliament). RV is supported in part by the Evans Medical Foundation and the Jay and Louis Coffman Endowment from the Department of Medicine, Boston University School of Medicine.
Funding Information:
JLS reports personal fees for consultancy from Apneo Therapeutics and Decimal.health, outside the submitted work. At the time of publication, JLS was employed by Vertex Pharmaceuticals. MN reports personal fees for consultancy from Daiichi Sankyo and AstraZeneca; honoraria from Roche; and grants from Merck, AstraZeneca, Canon Medical Systems and NIH (R01CA203636, U01CA209414, R01HL111024), outside the submitted work. HH reports grants from Canon Medical System Inc. and Konica-Minolta Inc., personal fees for consultancy from Mitsubishi Chemical Inc. and personal fees for advisory board work from Canon Medical System Inc., outside the submitted work. JM reports fees to her institution on her behalf for guest lecture/consultant outside the submitted work from Merck. GMH reports personal fees from Genentech, Boehringer Ingelheim, The Gerson Lehrman Group and Mitsubishi Chemical, outside the submitted work.
Publisher Copyright:
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022
Y1 - 2022
N2 - Background: Interstitial lung abnormalities (ILAs) are associated with increased mortality. It is unclear whether multimorbidity accounts for the mortality association or how strongly ILA is associated with mortality relative to other common age-Associated diseases. We determined the association of ILA with all-cause mortality adjusted for multimorbidity, compared mortality associated with ILA and prevalent cardiovascular disease (CVD), diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease and cancer and also determined the association between ILA and these diseases. Methods: We measured ILA (none, indeterminant, definite) using blinded reads of CT images, prevalent chronic diseases and potential confounders in two observational cohorts, the Framingham Heart Study (FHS) (n=2449) and Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik) (n=5180). We determined associations with mortality using Cox proportional hazards models and between ILA and diseases with multinomial logistic regression. Results: Over a median (IQR) follow-up of 8.8 (1.4) years in FHS and 12.0 (7.7) years in AGES-Reykjavik, in adjusted models, ILAs were significantly associated with increased mortality (HR, 95% CI 1.95, 1.23 to 3.08, p=0.0042, in FHS; HR 1.60, 1.41 to 1.82, p<0.0001, in AGES-Reykjavik) adjusted for multimorbidity. In both cohorts, the association of ILA with mortality was of similar magnitude to the association of most other diseases. In adjusted models, ILAs were associated only with prevalent kidney disease (OR, 95% CI 1.90, 1.01 to 3.57, p=0.0452) in FHS and with prevalent CVD (OR 1.42, 1.12 to 1.81, p=0.0040) in AGES-Reykjavik. Conclusions: ILAs were associated with mortality adjusted for multimorbidity and were similarly associated with increased mortality compared with several common chronic diseases. ILAs were not consistently associated with the prevalence of these diseases themselves.
AB - Background: Interstitial lung abnormalities (ILAs) are associated with increased mortality. It is unclear whether multimorbidity accounts for the mortality association or how strongly ILA is associated with mortality relative to other common age-Associated diseases. We determined the association of ILA with all-cause mortality adjusted for multimorbidity, compared mortality associated with ILA and prevalent cardiovascular disease (CVD), diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease and cancer and also determined the association between ILA and these diseases. Methods: We measured ILA (none, indeterminant, definite) using blinded reads of CT images, prevalent chronic diseases and potential confounders in two observational cohorts, the Framingham Heart Study (FHS) (n=2449) and Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik) (n=5180). We determined associations with mortality using Cox proportional hazards models and between ILA and diseases with multinomial logistic regression. Results: Over a median (IQR) follow-up of 8.8 (1.4) years in FHS and 12.0 (7.7) years in AGES-Reykjavik, in adjusted models, ILAs were significantly associated with increased mortality (HR, 95% CI 1.95, 1.23 to 3.08, p=0.0042, in FHS; HR 1.60, 1.41 to 1.82, p<0.0001, in AGES-Reykjavik) adjusted for multimorbidity. In both cohorts, the association of ILA with mortality was of similar magnitude to the association of most other diseases. In adjusted models, ILAs were associated only with prevalent kidney disease (OR, 95% CI 1.90, 1.01 to 3.57, p=0.0452) in FHS and with prevalent CVD (OR 1.42, 1.12 to 1.81, p=0.0040) in AGES-Reykjavik. Conclusions: ILAs were associated with mortality adjusted for multimorbidity and were similarly associated with increased mortality compared with several common chronic diseases. ILAs were not consistently associated with the prevalence of these diseases themselves.
KW - clinical epidemiology
KW - idiopathic pulmonary fibrosis
KW - imaging/CT MRI etc
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U2 - 10.1136/thoraxjnl-2021-218315
DO - 10.1136/thoraxjnl-2021-218315
M3 - Article
C2 - 35777957
AN - SCOPUS:85134682545
JO - Thorax
JF - Thorax
SN - 0040-6376
M1 - 218315
ER -