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Lower pulmonary function and cerebral subclinical abnormalities detected by MRI: the Atherosclerosis Risk in
1Department of Health Evaluation Sciences, Penn State University College of Medicine, Hershey 17033, USA. DLiao@psu.edu
Study Objectives:
To investigate the association between pulmonary function and (1) cerebral infarction and (2) white matter lesions (WMLs), identified by MRI and believed to represent subclinical lesions of arteriosclerosis, generalized hypoperfusion, or ischemia of the brain.
Design:
Population-based, cross-sectional study.
Setting:
Two communities in the United States.
Participants:
A sample of 1,917 African-American and white men and women 55 to 72 years old who were selected from the second follow-up examination of the Atherosclerosis Risk in Communities Study cohort.
Interventions:
Observational study.
Measurements And Results:
The lung function indexes, FEV1 and FVC, were assessed according to American Thoracic Society criteria. Subclinical cerebral infarction and WMLs were assessed by MRI. After adjusting for age, ethnicity, gender, height, and height squared, a 1-SD decrease of FEV1 in nonsmokers was associated with odds ratios (95% confidence interval [CI], 1.31 to 2.03) of 1.63 for infarction and 1.35 (95% CI, 1.08 to 1.69) for WMLs. Of those in the lowest quartile of FEV1, 15% had infarction and WMLs, in contrast to 6% of the individuals in the uppermost quartile of FEV1. Consistent associations were also observed by using FVC as an index of pulmonary function. Similar patterns of association were found among current smokers. The associations were not altered by additional adjustment of conventional risk factors of cardiovascular disease, comorbidity, or cognitive function.
Conclusion:
The results from this population-based study suggest that lower pulmonary function is associated with subclinical cerebral abnormalities.
Insights
Reduced lung function, measured by FEV1 and FVC, is linked to subclinical brain abnormalities like cerebral infarction and white matter lesions (WMLs). This association highlights a potential connection between respiratory health and cerebrovascular disease.
Area of Science:
- Pulmonary Medicine
- Neurology
- Epidemiology
Background:
- Cerebral infarction and white matter lesions (WMLs) are indicators of subclinical arteriosclerosis, hypoperfusion, or ischemia.
- Pulmonary function is a key indicator of overall respiratory health.
Purpose of the Study:
- To investigate the association between pulmonary function and subclinical cerebral abnormalities, specifically cerebral infarction and WMLs.
- To determine if reduced lung function is a risk factor for these brain lesions.
Main Methods:
- Population-based, cross-sectional study of 1,917 adults aged 55-72.
- Pulmonary function assessed using FEV1 and FVC.
- Cerebral infarction and WMLs identified via MRI.
Main Results:
- Lower FEV1 (forced expiratory volume in 1 second) was associated with increased odds of cerebral infarction and WMLs, even after adjusting for confounders.
- Individuals in the lowest quartile of FEV1 had a higher prevalence of infarction and WMLs compared to those in the highest quartile.
- Similar associations were observed with FVC (forced vital capacity) and in current smokers.
Conclusions:
- Lower pulmonary function is significantly associated with subclinical cerebral abnormalities.
- These findings suggest a link between respiratory health and brain health, potentially impacting cerebrovascular disease risk.