Associations of hiatus hernia with CT-based interstitial lung changes: the MESA Lung Study

Area of Science:

• Pulmonary Medicine
• Radiology
• Genetics

Background:

• Hiatus hernia (HH) is common in adults with pulmonary fibrosis.
• A potential association between HH and lung inflammation/fibrosis markers exists.

Purpose of the Study:

• To investigate the association between hiatus hernia (HH) and markers of lung inflammation and fibrosis.
• To explore if this association is stronger in MUC5B risk allele carriers.

Main Methods:

• Utilized CT scans from the Multi-Ethnic Study of Atherosclerosis (MESA) to assess HH and high attenuation areas (HAAs).
• Examined interstitial lung abnormalities (ILAs) and serum MMP-7 levels.
• Employed regression models to analyze associations, adjusting for multiple covariates.

Main Results:

• HH was associated with increased HAAs over time, especially in MUC5B risk allele carriers (interaction p=0.02).
• HH correlated with ILAs in individuals under 80 years old (OR 1.78).
• Higher serum MMP-7 levels were observed in smokers with HH (interaction p=0.04).

Conclusions:

• Hiatus hernia is associated with progressive lung changes (HAAs) and ILAs.
• The MUC5B genotype modifies the HH-lung fibrosis association.
• HH may be an early risk factor for interstitial lung disease.