Metabolic Syndrome Biomarkers of World Trade Center Airway Hyperreactivity: A 16-Year Prospective Cohort Study

Abstract

Airway hyperreactivity (AHR) related to environmental exposure is a significant public health risk worldwide. Similarly, metabolic syndrome (MetSyn), a risk factor for obstructive airway disease (OAD) and systemic inflammation, is a significant contributor to global adverse health. This prospective cohort study followed N = 7486 World Trade Center (WTC)-exposed male firefighters from 11 September 2001 (9/11) until 1 August 2017 and investigated N = 539 with newly developed AHR for clinical biomarkers of MetSyn and compared them to the non-AHR group. Male firefighters with normal lung function and no AHR pre-9/11 who had blood drawn from 9 September 2001–24 July 2002 were assessed. World Trade Center-Airway Hyperreactivity (WTC-AHR) was defined as either a positive bronchodilator response (BDR) or methacholine challenge test (MCT). The electronic medical record (EMR) was queried for their MetSyn characteristics (lipid profile, body mass index (BMI), glucose), and routine clinical biomarkers (such as complete blood counts). We modeled the association of MetSyn characteristics at the first post-9/11 exam with AHR. Those with AHR were significantly more likely to be older, have higher BMIs, have high intensity exposure, and have MetSyn. Smoking history was not associated with WTC-AHR. Those present on the morning of 9/11 had 224% increased risk of developing AHR, and those who arrived in the afternoon of 9/11 had a 75.9% increased risk. Having ≥3 MetSyn parameters increased the risk of WTC-AHR by 65.4%. Co-existing MetSyn and high WTC exposure are predictive of future AHR and suggest that systemic inflammation may be a contributor.

World Trade Center-Cardiorespiratory and Vascular Dysfunction: Assessing the Phenotype and Metabolome of a Murine Particulate Matter Exposure Model

“…Our study shows that a single exposure of WTC-PM is associated with acute and chronic cardiopulmonary changes. WTC-PM exposure has traditionally been known to cause pulmonary disease [7][8][9] . We demonstrate that there are early vascular and hemodynamic changes, evidence of hypermetabolic activity, collagen deposition, and oxidative stress following WTC-PM exposure.…”

Dietary Phenotype and Advanced Glycation End-Products Predict WTC-Obstructive Airways Disease: a Longitudinal Observational Study

“…(12)(13)(14)(15)(16)(17)(18)(19) Furthermore, metabolic biomarkers, elevated BMI, and a >2 kg/m 2 BMI increase predicted WTC-OAD. (15,(20)(21)(22)(23) Since high-caloric diets are key contributors to MetSyn, nutritional interventions to potentially reverse pulmonary dysfunction have been studied. (14)(15)(16) Our in vitro and in vivo models identi ed that the receptor for AGE(RAGE) is associated with lung dysfunction after WTC-particulate matter (WTC-PM) exposure.…”

“…(9)(10)(11) Speci cally, Mediterranean diets characterized by high consumption of fruits, vegetables, and sh, were associated with lower COPD, whereas, western diets were signi cantly associated with higher risk of newly diagnosed COPD. (12)(13)(14)(15)(16) Metabolic syndrome (MetSyn) is a risk factor of cardiovascular, lung disease, and World Trade Center-OAD (WTC-OAD). (15,16) It affects over 30% of US adults and 23% of participants in the Fire Department of New York (FDNY) WTC-Health Program (WTC-HP) program.…”

“…(12)(13)(14)(15)(16) Metabolic syndrome (MetSyn) is a risk factor of cardiovascular, lung disease, and World Trade Center-OAD (WTC-OAD). (15,16) It affects over 30% of US adults and 23% of participants in the Fire Department of New York (FDNY) WTC-Health Program (WTC-HP) program. (12)(13)(14)(15)(16)(17)(18)(19) Furthermore, metabolic biomarkers, elevated BMI, and a >2 kg/m 2 BMI increase predicted WTC-OAD.…”

“…(15,16) It affects over 30% of US adults and 23% of participants in the Fire Department of New York (FDNY) WTC-Health Program (WTC-HP) program. (12)(13)(14)(15)(16)(17)(18)(19) Furthermore, metabolic biomarkers, elevated BMI, and a >2 kg/m 2 BMI increase predicted WTC-OAD. (15,(20)(21)(22)(23) Since high-caloric diets are key contributors to MetSyn, nutritional interventions to potentially reverse pulmonary dysfunction have been studied.…”