Change in C-reactive protein levels and FEV1 decline: A longitudinal population-based study

Abstract

Reduced pulmonary function is an important predictor of cardiovascular morbidity and mortality. The mechanisms underlying this association are unknown but may involve systemic inflammation. We assessed the cross-sectional and longitudinal relationships between C-reactive protein (CRP) levels and forced expiratory volume in 1s (FEV1) and its decline in the general population, over a period of 8.5 years. The analyzes were based on 531 subjects (mean age at baseline: 37+/-7 years, 50% women and 42% non-smokers), recruited at two French centers participating in the European Community Respiratory Health Survey. Lung function was expressed as a percentage of predicted FEV1. CRP was measured centrally, by means of a highly sensitive assay. In cross-sectional analysis, FEV1 as a % of predicted values was negatively associated with serum CRP concentration (P=0.002). Multivariate adjustment did not alter these results (P=0.002). In longitudinal analysis, annual FEV1 decline tended to increase from the lower to the upper tertile for baseline CRP concentration but the association was borderline significant (P=0.14). Mean values of annual FEV1 decline were 26+/-32, 31+/-32, and 34+/-32 ml/year for the lower, middle and upper tertiles of baseline CRP concentration, respectively, after adjusting for potential confounders (P=0.09). Changes in CRP levels during follow-up were associated with annual FEV1 decline. The mean annual FEV1 declines in subjects with increasing CRP, in those with stable CRP and in those with decreasing CRP were 36+/-31, 30+/-31 and 24+/-31 ml/year, respectively (P<0.001). These findings were not affected by adjustment for potential confounders (P=0.002). In conclusion, increases in CRP levels over time were associated with a steeper FEV1 decline.

High-sensitive C-reactive protein is associated with reduced lung function in young adults

“…It is also possible that that study may have been biased by survival. In accordance with the present findings, SHAABAN et al [13] found an association between CRP at baseline and a decline in FEV1 in middle-aged subjects (average age 37 yrs) over a follow-up period of 8.5 yrs, although this association did not reach formal significance (p50.07). Additionally, plasma fibrinogen, another marker of systemic inflammation, was found to predict subsequent lung function decline in a 5-yr follow-up study of young American adults [12].…”

“…Cross-sectional associations between poor lung function and CRP have previously been shown in chronic obstructive pulmonary disease patients [22][23][24] and in healthy subjects [2,[13][14][15]25]. Longitudinal studies have also demonstrated that the decline in lung function predicts CRP levels at followup [14,15].…”

“…The temporal relationship between systemic inflammation and poor lung function is also unclear. Although several studies have explored this association [1,[10][11][12][13][14][15], each of these studies had certain limitations. Some of these studies were cross sectional in nature and unable to assess the temporal relationships [10,11].…”

“…Longitudinal studies have found that lung function decline was associated with raised levels of CRP at follow-up, but found little or no evidence that high levels of CRP predicted a subsequent decline in lung function. However, these studies have mostly been conducted in middle-aged individuals [13] or elderly subjects [1,15]; highsensitivity CRP measurements were not used on both occasions and the influence of low-grade inflammation may have been missed [12,14].…”

Longitudinal Change in FEV1 and FVC in Chronic Spinal Cord Injury

“…Studies assessing body fat distribution in SCI have demonstrated an 8 to 18% increase in fat mass compared with that in able-bodied persons (33,34). Although a greater BMI may result in mechanical loading of the chest wall and reduced pulmonary function, adiposity is also associated with greater levels of circulating markers of systemic inflammation that have been linked to reduced pulmonary function in ablebodied individuals (35)(36)(37)(38)(39). In participants with a normal BMI, an increase in BMI was associated with a significant increase in FEV 1 and FVC.…”