Adiposity influences airway wall thickness and the asthma phenotype of HIV-associated obstructive lung disease: a cross-sectional study

BMC Pulmonary Medicine

Research Article

Alex Ireland¹  Sally E. Wenzel¹  Danielle Camp¹  Joseph K. Leader¹  Deborah McMahon¹  Cathy Kessinger¹  Julia H. Barton¹  Renee Weinman¹  Meghan Fitzpatrick¹  Alison Morris²  Fernando Holguin³  Matthew R. Gingo⁴ 

[1] Department of Medicine, University of Pittsburgh, Pittsburgh, USA;Department of Medicine, University of Pittsburgh, Pittsburgh, USA;Department of Immunology, University of Pittsburgh, Pittsburgh, USA;Department of Medicine, University of Pittsburgh, Pittsburgh, USA;Department of Pediatrics, University of Pittsburgh, Pittsburgh, USA;Department of Medicine, University of Pittsburgh, Pittsburgh, USA;Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, 3459 Fifth Avenue, 628 NW, 15213, Pittsburgh, PA, USA;

关键词: HIV;    Asthma;    COPD;    Obstructive lung disease;    Obesity;    Lipodystrophy;    Adiponectin;   

DOI  :  10.1186/s12890-016-0274-5

 received in 2016-01-09, accepted in 2016-07-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAirflow obstruction, which encompasses several phenotypes, is common among HIV-infected individuals. Obesity and adipose-related inflammation are associated with both COPD (fixed airflow obstruction) and asthma (reversible airflow obstruction) in HIV-uninfected persons, but the relationship to airway inflammation and airflow obstruction in HIV-infected persons is unknown. The objective of this study was to determine if adiposity and adipose-associated inflammation are associated with airway obstruction phenotypes in HIV-infected persons.MethodsWe performed a cross-sectional analysis of 121 HIV-infected individuals assessed with pulmonary function testing, chest CT scans for measures of airway wall thickness (wall area percent [WA%]) and adipose tissue volumes (mediastinal and subcutaneous), as well as HIV- and adipose-related inflammatory markers. Participants were defined as COPD phenotype (post-bronchodilator FEV1/FVC < lower limit of normal) or asthma phenotype (doctor-diagnosed asthma or bronchodilator response). Pearson correlation coefficients were calculated between adipose measurements, WA%, and pulmonary function. Multivariable logistic and linear regression models were used to determine associations of airflow obstruction and airway remodeling (WA%) with adipose measurements and participant characteristics.ResultsTwenty-three (19 %) participants were classified as the COPD phenotype and 33 (27 %) were classified as the asthma phenotype. Body mass index (BMI) was similar between those with and without COPD, but higher in those with asthma compared to those without (mean [SD] 30.7 kg/m2 [8.1] vs. 26.5 kg/m2 [5.3], p = 0.008). WA% correlated with greater BMI (r = 0.55, p < 0.001) and volume of adipose tissue (subcutaneous, r = 0.40; p < 0.001; mediastinal, r = 0.25; p = 0.005). Multivariable regression found the COPD phenotype associated with greater age and pack-years smoking; the asthma phenotype with younger age, female gender, smoking history, and lower adiponectin levels; and greater WA% with greater BMI, younger age, higher soluble CD163, and higher CD4 counts.ConclusionsAdiposity and adipose-related inflammation are associated with an asthma phenotype, but not a COPD phenotype, of obstructive lung disease in HIV-infected persons. Airway wall thickness is associated with adiposity and inflammation. Adipose-related inflammation may play a role in HIV-associated asthma.

【 授权许可】

CC BY   
© The Author(s). 2016