Marilyn L Moy1, Merilee Teylan2, Nicole A Weston3, David R Gagnon4, Valery A Danilack5, Eric Garshick6. 1. Department of Veteran Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, Boston, MA; Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: marilyn.moy@va.gov. 2. Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA. 3. Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA; Department of Biostatistics, Boston University School of Public Health, Boston, MA. 4. VA Cooperative Studies, Boston, MA. 5. Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA; Department of Epidemiology, Brown University, Providence, RI. 6. Department of Veteran Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, Boston, MA; Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: Physical activity is an important clinical marker of disease status in COPD. COPD is also characterized by low-grade systemic inflammation. However, the relationship between physical activity and systemic inflammation in COPD is unclear. METHODS: We monitored daily step count, a directly measured physical activity, using the StepWatch Activity Monitor, an ankle-worn accelerometer, in 171 people with stable COPD. Exercise capacity was assessed with the 6-min walk test (6MWT). We measured plasma C-reactive protein (CRP) and IL-6 levels. Linear regression models examined the cross-sectional associations of daily step count and 6MWT distance with CRP and IL-6 levels. RESULTS: Subjects had a mean age 72±8 years and mean FEV1 1.5±0.57 L (54±20% predicted). Median daily step count was 5,203 (interquartile range [IQR], 3,627-7,024], CRP level was 2.4 mg/L (IQR, 1.2-5.0), and IL-6 level was 2.9 pg/mL (IQR, 2.0-5.1). Each 1,000-step increase in daily step count was associated with a 0.94 mg/L and 0.96 pg/mL decrease in CRP (P=.020) and IL-6 (P=.044) levels, respectively, adjusting for age, FEV1 % predicted, pack-years smoked, cardiac disease, current statin use, history of acute exacerbations, and season. There was a significant linear trend of increasing daily step count by quartiles and decreasing CRP (P=.0007) and IL-6 (P=.023) levels. Higher 6MWT distance was also significantly associated with lower CRP and IL-6 values. CONCLUSION: People with COPD who walked the most had the lowest plasma CRP and IL-6 levels. These results provide the conceptual basis to study whether an intervention to promote walking will reduce systemic inflammation in people with COPD.
BACKGROUND: Physical activity is an important clinical marker of disease status in COPD. COPD is also characterized by low-grade systemic inflammation. However, the relationship between physical activity and systemic inflammation in COPD is unclear. METHODS: We monitored daily step count, a directly measured physical activity, using the StepWatch Activity Monitor, an ankle-worn accelerometer, in 171 people with stable COPD. Exercise capacity was assessed with the 6-min walk test (6MWT). We measured plasma C-reactive protein (CRP) and IL-6 levels. Linear regression models examined the cross-sectional associations of daily step count and 6MWT distance with CRP and IL-6 levels. RESULTS: Subjects had a mean age 72±8 years and mean FEV1 1.5±0.57 L (54±20% predicted). Median daily step count was 5,203 (interquartile range [IQR], 3,627-7,024], CRP level was 2.4 mg/L (IQR, 1.2-5.0), and IL-6 level was 2.9 pg/mL (IQR, 2.0-5.1). Each 1,000-step increase in daily step count was associated with a 0.94 mg/L and 0.96 pg/mL decrease in CRP (P=.020) and IL-6 (P=.044) levels, respectively, adjusting for age, FEV1 % predicted, pack-years smoked, cardiac disease, current statin use, history of acute exacerbations, and season. There was a significant linear trend of increasing daily step count by quartiles and decreasing CRP (P=.0007) and IL-6 (P=.023) levels. Higher 6MWT distance was also significantly associated with lower CRP and IL-6 values. CONCLUSION:People with COPD who walked the most had the lowest plasma CRP and IL-6 levels. These results provide the conceptual basis to study whether an intervention to promote walking will reduce systemic inflammation in people with COPD.
Authors: Marilyn L Moy; Riley J Collins; Carlos H Martinez; Reema Kadri; Pia Roman; Robert G Holleman; Hyungjin Myra Kim; Huong Q Nguyen; Miriam D Cohen; David E Goodrich; Nicholas D Giardino; Caroline R Richardson Journal: Chest Date: 2015-07 Impact factor: 9.410
Authors: Olaf Holz; David S DeLuca; Stefan Roepcke; Thomas Illig; Klaus M Weinberger; Christian Schudt; Jens M Hohlfeld Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-01-06
Authors: Emily S Wan; Ana Kantorowski; Madeline Polak; Reema Kadri; Caroline R Richardson; David R Gagnon; Eric Garshick; Marilyn L Moy Journal: Respir Med Date: 2020-01-11 Impact factor: 3.415
Authors: Valentin Prieto-Centurion; Nina Bracken; Lourdes Norwick; Farhan Zaidi; Amelia A Mutso; Victoria Morken; David B Coultas; Cynthia S Rand; David X Marquez; Jerry A Krishnan Journal: Chronic Obstr Pulm Dis Date: 2016
Authors: Christine M Fitzgibbons; Rebekah L Goldstein; Daniel J Gottlieb; Marilyn L Moy Journal: J Clin Sleep Med Date: 2019-07-15 Impact factor: 4.062
Authors: Carlos H Martinez; Marilyn L Moy; Huong Q Nguyen; Miriam Cohen; Reema Kadri; Pia Roman; Robert G Holleman; Hyungjin Myra Kim; David E Goodrich; Nicholas D Giardino; Caroline R Richardson Journal: BMC Pulm Med Date: 2014-02-03 Impact factor: 3.317