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Original Research: Aging |

Aging, Diabetes, and Hypertension Are Associated With Decreased Nasal Mucociliary ClearanceFactors Affecting Mucociliary Clearance

Janaína Proença de Oliveira-Maul, MSc; Heráclito Barbosa de Carvalho, MD, PhD; Danielle Miyuki Goto, PhD; Raphaela Mendonça Maia, BSc; Claudia Fló, PhD; Viviane Barnabé, PhD; Denise Reis Franco, MD; Simon Benabou, MD; Monica Rodrigues Perracini, PhD; Wilson Jacob-Filho, MD, PhD; Paulo Hilário Nascimento Saldiva, MD, PhD; Geraldo Lorenzi-Filho, MD, PhD; Bruce K. Rubin, MD, MEngr, MBA, FCCP; Naomi Kondo Nakagawa, PhD
Author and Funding Information

From the Department of Physiotherapy, Communication Science and Disorders, Occupational Therapy, LIM 34 (Ms Proença de Oliveira-Maul and Drs Goto, Barnabé, and Nakagawa); the Department of Pathology, LIM 05 (Ms Proença de Oliveira-Maul and Drs Goto, Barnabé, Benabou, Saldiva, and Nakagawa); the Department of Preventive Medicine, LIM 39 (Dr Barbosa de Carvalho); the Department of Geriatrics (Drs Fló and Jacob-Filho); the Division of Pneumology (Dr Lorenzi-Filho), Heart Institute, Faculdade de Medicina da Universidade de São Paulo; Master of Science Program in Physiotherapy (Ms Maia and Dr Perracini), University of São Paulo City; and Associação de Diabetes Juvenil (Dr Franco), São Paulo, Brazil; and the Virginia Commonwealth University Department of Pediatrics (Dr Rubin) and Children’s Hospital of Richmond at Virginia Commonwealth University (Dr Rubin), Richmond, VA.

Correspondence to: Naomi Kondo Nakagawa, PhD, Faculdade de Medicina da Universidade de São Paulo, 455 Av. Dr. Arnaldo room 1150, Cerqueira Cesar, São Paulo, Brazil, CEP 01246-903; e-mail: naomi.kondo@usp.br


Funding/Support: This study received financial support from Fundação de Amparo à Pesquisa do Estado de São Paulo [FAPESP 07/51605-9].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(4):1091-1097. doi:10.1378/chest.12-1183
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Background:  We showed previously that nasal mucociliary clearance was decreased in critically ill elderly subjects, most of whom had diabetes mellitus (DM) and/or hypertension (HTN). To determine if these changes were due to the effects of aging, disease, or critical illness, we studied nasal mucociliary clearance and mucus properties in an ambulatory population consisting of young, elderly, and healthy subjects and those with DM, HTN, or both.

Methods:  Of 440 subjects contacted, 252 entered the study. The subjects were divided into the following groups: (1) healthy (n = 79, 18-94 years, 50 men) and (2) DM and/or HTN, of which 37 had DM (14-90 years, 12 men), 52 had HTN (23-90 years, 12 men), and 84 had both DM and HTN (25-82 years, 33 men). Subjects were also grouped by age: < 40 years, 40 to 59 years, and ≥ 60 years. We assessed demographic and clinical data, quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire, nasal mucociliary clearance using the saccharine transit test (STT), and in vitro mucus properties by examining the sneeze (high airflow) clearability and contact angle. A logistic regression analysis for prolonged STT > 12 min was used, and we controlled for age, sex, and diseases.

Results:  Subjects aged > 60 years reported a decreased SF-36 physical component relative to other age groups. Sex, BMI, BP, heart rate, pulse oximetry, blood glucose level, and mucus properties were not associated with prolonged STT. Aging and DM and/or HTN independently increased the risk of prolonged STT.

Conclusions:  Aging and DM, HTN, or both diseases are independently associated with decreased nasal mucociliary clearance. This may predispose toward respiratory infections.

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