Metabolic syndrome biomarkers predict lung function impairment after exposure to WTC dust

Metabolic syndrome biomarkers predict subsequent decline in lung function after particulate exposure, according to new research involving rescue personnel exposed to World Trade Center (WTC) dust.

In a nested case-control study of 327 non-smoking FDNY 9/11 rescue workers, biomarkers measured within six months of exposure to WTC dust predicted decline of forced expiratory volume in one second () over the next six years.

"Study participants with dyslipidemia, elevated heart rate or elevated leptin levels had a significantly increased risk of developing abnormal during follow-up," said Anna Nolan, MD, MS, assistant professor of Medicine and at NYU Langone Medical Center. "In contrast, elevated amylin levels reduced the risk of developing abnormal FEV1 levels."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and .

This case-control study was nested within a larger longitudinally followed cohort. All subjects had normal lung function prior to 9/11. Cases (n = 109) were defined as having FEV1 values below the lower limit of normal at follow-up, while controls (n = 218) were defined as having FEV1 at or above the lower limit of normal. Biomarkers were available for 71 cases and 166 controls. Lung function in cases continually declined in the median 28 months between baseline and follow-up examinations, while lung function improved in controls.

In a model adjusting for age, race, and WTC arrival time, dyslipidemia (≥150mg/dL and HDL<40mg/dL) increased the odds of being a case three-fold, elevated (≥66 bpm) increased the odds more than two-fold, and elevated leptin (≥10,300 pg/mL) increased the odds three-fold. Elevated amylin levels (≥116 pg/mL) decreased the odds of being a case by 84 percent. "This is the first report in humans showing an association between amylin and lung function," Dr. Nolan said. "There are amylin receptors in the lungs, and amylin has been shown to reduce leptin resistance. The protection offered by amylin in this study may have been mediated by these effects."

"These findings suggest that systemic inflammation, a hallmark of the metabolic syndrome, may play a role in promoting lung function impairment in patients with particulate exposure," Dr. Nolan said. "Given the high prevalence of the metabolic syndrome in industrialized nations and the rising incidence in developing nations with high ambient particulate levels, the relationship between these disorders is of considerable importance."

The study had a few limitations. Use of a single cohort of rescue workers limits extrapolation of these results to other cohorts. There was no unexposed control group in this study, so replication of these findings in populations with and without exposure to particulate matter is needed. Finally, other possible causes of lung dysfunction were not explored.

"Our findings in WTC rescue workers highlight the importance of conducting rapid medical monitoring and sample banking following a disaster," said Dr. Nolan. "If we can identify individuals at greater risk of developing lung function impairment, we can initiate appropriate interventions earlier."

add to favorites email to friend print save as pdf

Related Stories

Love handles put the squeeze on lungs

Mar 06, 2009

There's more bad news for people who carry excess weight around their waists: Not only is abdominal obesity associated with diabetes, hypertension, cardiovascular disease and a host of other health problems collectively known ...

Breastfed babies breathe better, except when mom has asthma

Nov 01, 2007

When it comes to feeding babies, the old adage “breast is best” certainly holds true, with breastfed babies having less diarrhea and fewer ear infections and incidents of wheezing in early life. However, the positive ...

Recommended for you

Ebola in mind, US colleges screen some students

17 hours ago

University students from West Africa may be subject to extra health checks when they arrive to study in the United States as administrators try to insulate their campuses from the worst Ebola outbreak in ...

WHO: More Ebola cases in past week than any other

18 hours ago

The past week has seen the highest increase of Ebola cases since the outbreak in West Africa began, the World Health Organization said Friday, offering more evidence that the crisis is worsening.

User comments