Biomarkers of metabolic syndrome predict accelerated decline of lung function in NYC firefighters that were exposed to WTC particulates.
Naveed-B; Comfort-AL; Ferrier-N; Kasturiarachchi-KJ; Rom-WN; Prezant-DJ; Weiden-MD; Nolan-A
Am J Respir Crit Care Med 2011 May; 183(Meeting Abstracts):A4795
RATIONALE: In the first year post 9/11/2001, there was a decline of 439 mL in FEV1 in FDNY rescue workers, stabilizing to a 25 ml/year decline in the subsequent seven years. Airflow obstruction predominated in 1720 individuals who sought a subspecialty pulmonary evaluation for treatment. We noted that the most severely obstructed patients had significant weight gain. This well phenotyped cohort had serum drawn within the five months post 9/11/2001, allowing us to investigate relationships of metabolic syndrome biomarkers and decline in lung function. METHODS: The treatment cohort (N=1720) was stratified by FEV1 into either obstructed, FEV1<76% predicted (Lower limit of normal for this cohort), or normal airflow, FEV1>76%. A pilot analysis assayed 41 patients' serum drawn 2.88 +/= 0.99 months following 9/11 for 15 biomarkers of metabolic syndrome by Luminex; 10 cases were obstructed and 31 were normal. All patients had normal pre-9/11 lung function. Serum cholesterol and triglycerides were available on 157 patients, 20/157 were obstructed. The subspecialty PFT was used to stratify patients, months post-9/11. Data represented as means +/= SD and significance was assessed based on p = 0.05 by t-test. RESULTS: BMIs at the time of serum sampling were no different between individuals with obstruction and normal FEV1. However, at subspecialty PFT, the obstructed patients had higher BMIs. The cohort with the greatest lung function decline had significantly greater cholesterol and Cholesterol/HDL ratios, with a trend towards elevated triglyceride levels. The subgroup with available Luminex data showed higher levels of sE-Selectin, tPAI-1, and s-ICAM in the obstructed patients. The same cohort had a trend towards elevated levels of C-peptide. Individuals with obstruction at treatment entry had accelerated decline in lung function post 9/11, increased airway reactivity, and evidence of air trapping based on elevated RV when compared to those who maintained a normal FEV1%. CONCLUSIONS: Blood drawn within 5 months of WTC exposure identified a subgroup of patients with markers of metabolic syndrome. This subgroup had more weight gain and greater decline in lung function during the next 7 years. The finding of metabolic syndrome biomarkers prior to decline in lung function raises the possibility that the combination of irritant exposure and mediators of metabolic syndrome interact and promote lung injury.
Particulates; Particulate-dust; Employee-exposure; Fire-fighters; Emergency-responders; Rescue-workers; Airborne-particles; Airborne-dusts; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Biomarkers; Pulmonary-function; Blood-serum; Airway-obstruction; Metabolic-study; Bioassays; Serum-cholesterol; Pulmonary-function-tests; Weight-measurement; Peptides
B. Naveed, New York University Division of Pulmonary and Critical Care, New York, NY
American Journal of Respiratory and Critical Care Medicine
New York City Fire Department