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Thorax 2006;61:10-16 doi:10.1136/thx.2004.034181
  • Chronic obstructive pulmonary disease

Inflammatory markers are associated with ventilatory limitation and muscle dysfunction in obstructive lung disease in well functioning elderly subjects

  1. S Yende1,
  2. G W Waterer2,
  3. E A Tolley3,
  4. A B Newman4,
  5. D C Bauer5,
  6. D R Taaffe6,
  7. R Jensen7,
  8. R Crapo7,
  9. S Rubin5,
  10. M Nevitt5,
  11. E M Simonsick8,
  12. S Satterfield3,
  13. T Harris9,
  14. S B Kritchevsky10
  1. 1CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
  2. 2Department of Medicine, University of Western Australia, Perth, Australia
  3. 3Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
  4. 4Division of Geriatric Medicine, University of Pittsburgh, PA, USA
  5. 5Preventive Sciences Group, University of California, San Francisco, CA, USA
  6. 6School of Human Movement Studies, University of Queensland, Australia
  7. 7Pulmonary Division, LDS Hospital and University of Utah, Salt Lake City, Utah, USA
  8. 8Clinical Research Branch, National Institute of Aging, Baltimore, MD, USA
  9. 9Geriatric Epidemiology Section, National Institute of Aging, Bethesda, MD, USA
  10. 10Sticht Center on Aging, Wake Forest University School of Medicine, Winston Salem, NC, USA
  1. Correspondence to:
    Dr S Yende
    Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15238, USA; yendes{at}upmc.edu
  • Received 2 September 2004
  • Accepted 18 October 2005
  • Published Online First 11 November 2005

Abstract

Background: Inflammatory markers are increased in chronic obstructive pulmonary disease (COPD) and are hypothesised to play an important part in muscle dysfunction and exercise intolerance.

Methods: The Health Aging and Body Composition (Health ABC) study is a prospective observational cohort of well functioning individuals aged 70–79 years. A cross sectional analysis of the baseline data was conducted to examine the association between inflammatory markers and ventilatory limitation, muscle strength, and exercise capacity. These associations were compared in participants with and without obstructive lung disease (OLD).

Results: Of the 3075 participants enrolled in the Health ABC cohort, OLD was identified by spirometric testing in 268 participants and 2005 participants had normal spirometric results. Of the participants with OLD, 35%, 38%, and 27% participants had mild, moderate, and severe OLD, respectively. Participants with OLD had lower quadriceps strength (102.5 Nm v 108.9 Nm, p = 0.02), lower maximum inspiratory pressure (64.7 cm H2O v 74.2 cm H2O, p<0.0001), higher systemic interleukin (IL)-6 levels (2.6 pg/ml v 2.2 pg/ml, p<0.0001), and higher C-reactive protein (CRP) levels (3.5 mg/l v 2.5 mg/l, p<0.0001) than those with normal spirometry. In participants with OLD and those with normal spirometry, forced expiratory volume in 1 second (FEV1) was associated with IL-6 (adjusted regression coefficients (β) = −5.3 (95% CI −9.1 to−1.5) and −3.1 (95% CI −4.3 to −1.9), respectively). IL-6 and TNF were also associated with quadriceps strength among participants with OLD and those with normal spirometry (β = −6.4 (95% CI −12.8 to −0.03) and −3.4 (95% CI −5.4 to −1.3), respectively, for IL-6 and β = −10.1 (95% CI −18.7 to −1.5) and −3.8 (95% CI −7 to −0.6), respectively, for TNF). IL-6, quadriceps strength, and maximum inspiratory pressures were independent predictors of reduced exercise capacity in both groups.

Conclusions: In well functioning elderly subjects with or without OLD, IL-6 is associated with reduced FEV1, quadriceps strength, and exercise capacity.

Footnotes

  • Published Online First 11 November 2005

  • This study was supported by NIA contracts N01-AG-6-2101, N01-AG-6-2103, R01-HL-074104, and N01-AG-6-2106

  • None of the authors has any competing interests to declare.

  • This work was performed while Dr Yende was at the Division of Pulmonary and Critical Care Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

    The study was approved by the Institutional Review Board at the University of Tennessee, Memphis and at the University of Pittsburgh, Pennsylvania.

This Article

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  4. All versions of this article:
    1. thx.2004.034181v1
    2. 61/1/10 most recent

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