Metabolic Syndrome Biomarkers Predict Lung Function Impairment

Abstract

Rationale:Cross-sectional studies demonstrate an association between metabolic syndrome and impaired lung function. Objectives: To define if metabolic syndrome biomarkers are risk factors for loss of lung function after irritant exposure. Methods: A nested case-control study of Fire Department of New York personnel with normal pre-September 11th FEV 1 and who presented for subspecialty pulmonary evaluation before March 10, 2008. We correlated metabolic syndrome biomarkers obtained within 6 months of World Trade Center dust exposure with subsequent FEV 1 . FEV 1 at subspecialty pulmonary evaluation within 6.5 years defined disease status; cases had FEV 1 less than lower limit of normal, whereas control subjects had FEV 1 greater than or equal to lower limit of normal. Measurements and Main Results: Clinical data and serum sampled at the first monitoring examination within 6 months of September 11, 2001, assessed body mass index, heart rate, serum glucose, triglycerides and high-density lipoprotein (HDL), leptin, pancreatic polypeptide, and amylin. Cases and control subjects had significant differences in HDL less than 40 mg/dl with triglycerides greater than or equal to 150 mg/dl, heart rate greater than or equal to 66 bpm, and leptin greater than or equal to 10,300 pg/ml. Each increased the odds of abnormal FEV 1 at pulmonary evaluation by more than twofold, whereas amylin greater than or equal to 116 pg/ml decreased the odds by 84%, in a multibiomarker model adjusting for age, race, body mass index, and World Trade Center arrival time. This model had a sensitivity of 41%, a specificity of 86%, and a receiver operating characteristic area under the curve of 0.77. Conclusions: Abnormal triglycerides and HDL and elevated heart rate and leptin are independent risk factors of greater susceptibility to lung function impairment after September 11, 2001, whereas elevated amylin is protective. Metabolic biomarkers are predictors of lung disease, and may be useful for assessing risk of impaired lung function in response to particulate inhalation.

Association of Pulmonary Function with Adiposity and Metabolic Abnormalities in Urban Minority Adolescents

“…These findings extend the associations between insulin resistance and pulmonary function reported in adults (10,11) into the pediatric population.…”

“…Although inflammation (9) and adiposity associated with the mechanical load of truncal fat are proposed to be causative mechanisms for the alteration of pulmonary function among obese persons (5), there is emerging evidence that metabolic abnormalities may also influence pulmonary function (10,11). Obesity is associated with metabolic abnormalities, including hyperinsulinemia, insulin resistance (12), and dyslipidemia (13).…”

“…Insulin resistance and its surrogate clinical marker, acanthosis nigricans, are more prevalent in children with asthma than in children without asthma (14)(15)(16). Dyslipidemia has been associated with wheeze (17) and insulin resistance with incident asthma (18) and with lower airway obstruction among adults (10,11). However, little is known about the association between metabolic abnormalities and pulmonary function among children.…”

Relationship between leptin and lung function in young healthy children

“…Leptin increased the odds of abnormal FEV1 by more than twofold after adjustment for body mass index [11]. This longitudinal study supports the hypothesis that leptin has a direct effect on the airways, making reverse causation less likely.…”

Adipokines, asymmetrical dimethylarginine, and pulmonary function in adolescents with asthma and obesity

“…There is an emerging evidence that metabolic abnormalities may also affect pulmonary function [20][21]. Obesity is associated with dyslipidemia, which has been associated with wheeze [22].…”