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Original Research |

Percent emphysema and daily motor activity levels in the general population: Multi-Ethnic Study of Atherosclerosis

Christian M. Lo Cascio, MD; Mirja Quante, MD; Eric A. Hoffman, PhD; Alain G. Bertoni, MD, MPH; Carrie P. Aaron, MD; Joseph E. Schwartz, PhD; Mark V. Avdalovic, MD; Vincent S. Fan, MD, MPH; Gina S. Lovasi, PhD, MPH; Steven M. Kawut, MD, MS; John H.M. Austin, MD; Susan Redline, MD, MPH; R. Graham Barr, MD, DrPH
Author and Funding Information

Summary conflict of interest statements

CML, MQ, AGB, CPA, JES, MVA, VSF, GSL, SMK, JHMA, SR and RGB reported no conflict of interest. EAH is the founder and co-owner of VIDA Diagnostics

Funding

NIH/NHLBI R01-HL077612, R01-HL093081, R01-HL098433, N01-HC95159-HC95169, UL1-TR000040; EPA RD83169701

*"The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government."

1Department of Medicine, Columbia University, New York, NY

2Department of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA

3Department of Internal Medicine, University of Iowa, Iowa City, IA

4Department of Epidemiology and Prevention, Wake Forest University, Winston-Salem, NC

5Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY

6Department of Internal Medicine, UC Davis School of Medicine, Sacramento, CA

7Staff Physician, VA Puget Sound Health Care System, Seattle WA*

8Department of Medicine, University of Washington, Seattle, WA

9Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

10Department of Radiology, Columbia University, New York, NY

Corresponding Author: R. Graham Barr, MD, DrPH, Columbia University Medical Center, Presbyterian Hospital 9 E Room 105, 630 W 168th St, New York, NY 10032.


Copyright 2016, . All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.11.033
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Abstract

Background  Chronic obstructive pulmonary disease (COPD) is associated with reduced physical capacity. However, it is unclear whether pulmonary emphysema, which can occur without COPD, is associated with reduced physical activity in daily life, particularly among people without COPD and never smokers. We hypothesized that greater percentage of emphysema-like lung on CT scan is associated with reduced physical activity assessed by actigraphy and self-report.

Methods  The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled participants free of clinical cardiovascular disease from the general population. Percent emphysema was defined as percentage of voxels below -950 HU on full-lung CT scans. Physical activity was measured by wrist actigraphy over 7 days and questionnaire. Multivariable linear regression was used to adjust for age, gender, race/ethnicity, height, weight, education, smoking, pack-years, and lung function.

Main results  Among 1,435 participants with actigraphy and lung measures, 47% had never smoked and 8% had COPD. Percent emphysema was associated with lower activity levels on actigraphy (p=0.001), corresponding to 1.5 hour less per week of moderately paced walking for the average participant in quintile 2 vs. 4 of percent emphysema. This association was significant among participants without COPD (p=0.004), among ever (p=0.01) and never smokers (p=0.03). It was also independent of coronary artery calcium and left ventricular ejection fraction. There was no evidence that percent emphysema was associated with self-reported activity levels.

Conclusions  Percent emphysema was associated with decreased physical activity in daily life objectively assessed by actigraphy in the general population, among participants without COPD and non-smokers.


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