Lung Function Decline and Disease Risk from Young Adulthood to Middle Age

从青年期到中年期的肺功能下降和疾病风险

基本信息

批准号：
8839289
负责人：
RAVI KALHAN
金额：
$ 71.06万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8839289
关键词：
Adverse effects Age Ancillary Study Blood Blood Vessels Bronchodilator Agents Caliber Cardiac Cardiopulmonary Cardiovascular Diseases Cardiovascular Manifestation Cardiovascular system Cause of Death Chronic Obstructive Airway Disease Cohort Studies Coronary Artery Risk Development in Young Adults Study Coronary artery Data Development Disease Enrollment Evolution Fibrinogen Functional disorder Future Goals Health Heart Heart Diseases Heart Hypertrophy Hypertension Hypertrophy Incidence Individual Inflammation Intercellular adhesion molecule 1 Investigation Left Life Lung Lung diseases Measures Minority Myocardial dysfunction Obstruction Outcome P-Selectin Participant Pattern Phenotype Physiology Preventive Prospective Studies Proteins Public Health Pulmonary Emphysema Pulmonary Function Test/Forced Expiratory Volume 1 Pulmonary artery structure Pulmonary veins Respiratory physiology Risk Risk Factors Risk Reduction Selectins Serological Side Smoker Smoking Spirometry Structure Testing United States Vital capacity X-Ray Computed Tomography aged cardiovascular risk factor cigarette smoking cohort density disorder risk endothelial dysfunction inflammatory marker innovation insight middle age population based pressure young adult

项目摘要

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. Although smoking is a major risk factor for COPD, only a minority of smokers develops COPD. Markers that predict risk of future COPD in young adults would be valuable to target risk reduction strategies and identify subclinical disease. Although COPD is classically defined by obstructive lung physiology, many individuals, including smokers, have spirometric restrictive physiology. Reduced lung function, whether manifesting as COPD or restriction, is associated with adverse cardiovascular outcomes. Our long-term goals are to identify subclinical manifestations of COPD and other lung disease and explore why heart and lung disease co-exist. This is an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study's year 30 examination. We will add pre- and post-bronchodilator spirometry to the exam and evaluate the lung parenchymal and vascular structure on cardiac CT scans from year 25. Informed by our preliminary data which documents that markers of systemic inflammation and endothelial dysfunction are associated with subsequent lung function decline in young adults, that lung function decline in young adults is associated with incident hypertension, and that there is a divergence in cardiac structure and function depending on the pattern of lung function decline, we propose the following specific aims: (1) To evaluate factors in young adults that predict incident COPD and/or restriction; (2) To determine whether incident COPD and incident restriction are associated with distinct cardiac structural and functional changes; and (3) To determine the lung structural and intrathoracic vascular changes associated with incident COPD and incident restriction. We will test the hypothesis that early life markers of systemic inflammation and endothelial dysfunction are associated with risk of subsequent lung disease and explore whether different inflammatory markers predict different lung phenotypes. We will then evaluate the cardiac structural changes associated with different lung phenotypes and evaluate the lung structural and pulmonary vascular alterations that may explain the concurrently evolving cardiovascular findings associated with developing lung disease. These studies will describe the subclinical manifestations of lung disease, identify markers that predict risk of future lung disease, and expand our understanding of heart-lung interactions as they evolve from health in young adults to disease in middle age.

描述（由申请人提供）：慢性阻塞性肺疾病（COPD）是美国第三大死亡原因。尽管吸烟是COPD的主要危险因素，但只有少数吸烟者会发展COPD。预测年轻人未来COPD风险的标志物对于降低风险策略并确定亚临床疾病是有价值的。尽管COPD经典地由阻塞性肺部生理学定义，但包括吸烟者在内的许多人都有肺部限制性生理。降低的肺功能，无论是表现为COPD还是限制，都与心血管不良结果有关。我们的长期目标是确定COPD和其他肺部疾病的亚临床表现，并探讨为什么心脏和肺部疾病共存。这是对年轻人冠状动脉风险发展（Cardia）同类研究30年级考试的辅助研究。 We will add pre- and post-bronchodilator spirometry to the exam and evaluate the lung parenchymal and vascular structure on cardiac CT scans from year 25. Informed by our preliminary data which documents that markers of systemic inflammation and endothelial dysfunction are associated with subsequent lung function decline in young adults, that lung function decline in young adults is associated with incident hypertension, and that there is a divergence在心脏结构和功能取决于肺功能下降的模式下，我们提出以下特定目的：（1）评估预测事件COPD和/或限制的年轻人的因素；（2）确定事件COPD和入射限制是否与不同的心脏结构和功能变化有关；（3）确定与事件COPD和事件限制相关的肺结构和胸前血管变化。我们将检验以下假设：系统性炎症和内皮功能障碍的早期生命标志物与随后的肺部疾病的风险有关，并探索不同的炎症标志物是否预测了不同的肺表型。然后，我们将评估与不同的肺表型相关的心脏结构变化，并评估肺结构和肺血管改变，这可能解释了同时发展的与发展肺部疾病相关的心血管发现结果。这些研究将描述肺部疾病的亚临床表现，确定预测未来肺部疾病风险的标志物，并扩展我们对心肺相互作用的理解，因为它们从年轻人的健康发展为中年疾病。