Christian M Lo Cascio1, Mirja Quante2, Eric A Hoffman3, Alain G Bertoni4, Carrie P Aaron1, Joseph E Schwartz5, Mark V Avdalovic6, Vincent S Fan7, Gina S Lovasi1, Steven M Kawut8, John H M Austin9, Susan Redline2, R Graham Barr10. 1. Department of Medicine, Columbia University, New York, NY. 2. Department of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. 3. Department of Internal Medicine, University of Iowa, Iowa City, IA. 4. Department of Epidemiology and Prevention, Wake Forest University, Winston-Salem, NC. 5. Department of Medicine, Columbia University, New York, NY; Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, NY. 6. Department of Internal Medicine, UC Davis School of Medicine, Sacramento, CA. 7. VA Puget Sound Health Care System, Seattle, WA; Department of Medicine, University of Washington, Seattle, WA. 8. Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. 9. Department of Radiology, Columbia University, New York, NY. 10. Department of Medicine, Columbia University, New York, NY. Electronic address: rgb9@columbia.edu.
Abstract
BACKGROUND: 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 < -950 Hounsfield units on full-lung CT scans. Physical activity was measured by wrist actigraphy over 7 days and a questionnaire. Multivariable linear regression was used to adjust for age, sex, race/ethnicity, height, weight, education, smoking, pack-years, and lung function. 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 = .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 = .004) and among ever (P = .01) and never smokers (P = .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 nonsmokers.
BACKGROUND: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 < -950 Hounsfield units on full-lung CT scans. Physical activity was measured by wrist actigraphy over 7 days and a questionnaire. Multivariable linear regression was used to adjust for age, sex, race/ethnicity, height, weight, education, smoking, pack-years, and lung function. 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 = .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 = .004) and among ever (P = .01) and never smokers (P = .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 nonsmokers.
Authors: Henrik Watz; Fabio Pitta; Carolyn L Rochester; Judith Garcia-Aymerich; Richard ZuWallack; Thierry Troosters; Anouk W Vaes; Milo A Puhan; Melissa Jehn; Michael I Polkey; Ioannis Vogiatzis; Enrico M Clini; Michael Toth; Elena Gimeno-Santos; Benjamin Waschki; Cristobal Esteban; Maurice Hayot; Richard Casaburi; Janos Porszasz; Edward McAuley; Sally J Singh; Daniel Langer; Emiel F M Wouters; Helgo Magnussen; Martijn A Spruit Journal: Eur Respir J Date: 2014-10-30 Impact factor: 16.671
Authors: Ani Manichaikul; Eric A Hoffman; Joanna Smolonska; Wei Gao; Michael H Cho; Heather Baumhauer; Matthew Budoff; John H M Austin; George R Washko; J Jeffrey Carr; Joel D Kaufman; Tess Pottinger; Charles A Powell; Cisca Wijmenga; Pieter Zanen; Harry J M Groen; Dirkje S Postma; Adam Wanner; Farshid N Rouhani; Mark L Brantly; Rhea Powell; Benjamin M Smith; Dan Rabinowitz; Leslie J Raffel; Karen D Hinckley Stukovsky; James D Crapo; Terri H Beaty; John E Hokanson; Edwin K Silverman; Josée Dupuis; George T O'Connor; H Marike Boezen; Stephen S Rich; R Graham Barr Journal: Am J Respir Crit Care Med Date: 2014-02-15 Impact factor: 21.405
Authors: R Graham Barr; David A Bluemke; Firas S Ahmed; J Jeffery Carr; Paul L Enright; Eric A Hoffman; Rui Jiang; Steven M Kawut; Richard A Kronmal; João A C Lima; Eyal Shahar; Lewis J Smith; Karol E Watson Journal: N Engl J Med Date: 2010-01-21 Impact factor: 91.245
Authors: Robert Detrano; Alan D Guerci; J Jeffrey Carr; Diane E Bild; Gregory Burke; Aaron R Folsom; Kiang Liu; Steven Shea; Moyses Szklo; David A Bluemke; Daniel H O'Leary; Russell Tracy; Karol Watson; Nathan D Wong; Richard A Kronmal Journal: N Engl J Med Date: 2008-03-27 Impact factor: 91.245
Authors: Judith Garcia-Aymerich; Ignasi Serra; Federico P Gómez; Eva Farrero; Eva Balcells; Diego A Rodríguez; Jordi de Batlle; Elena Gimeno; David Donaire-Gonzalez; Mauricio Orozco-Levi; Jaume Sauleda; Joaquim Gea; Robert Rodriguez-Roisin; Josep Roca; Àlvar G Agustí; Josep M Antó Journal: Chest Date: 2009-03-02 Impact factor: 9.410
Authors: Elena Gimeno-Santos; Anja Frei; Claudia Steurer-Stey; Jordi de Batlle; Roberto A Rabinovich; Yogini Raste; Nicholas S Hopkinson; Michael I Polkey; Hans van Remoortel; Thierry Troosters; Karoly Kulich; Niklas Karlsson; Milo A Puhan; Judith Garcia-Aymerich Journal: Thorax Date: 2014-02-20 Impact factor: 9.139
Authors: Fernando J Martinez; MeiLan K Han; James P Allinson; R Graham Barr; Richard C Boucher; Peter M A Calverley; Bartolome R Celli; Stephanie A Christenson; Ronald G Crystal; Malin Fagerås; Christine M Freeman; Lars Groenke; Eric A Hoffman; Mehmet Kesimer; Kostantinos Kostikas; Robert Paine; Shahin Rafii; Stephen I Rennard; Leopoldo N Segal; Renat Shaykhiev; Christopher Stevenson; Ruth Tal-Singer; Jørgen Vestbo; Prescott G Woodruff; Jeffrey L Curtis; Jadwiga A Wedzicha Journal: Am J Respir Crit Care Med Date: 2018-06-15 Impact factor: 21.405
Authors: Jingjing Liang; Brian E Cade; Karen Y He; Heming Wang; Jiwon Lee; Tamar Sofer; Stephanie Williams; Ruitong Li; Han Chen; Daniel J Gottlieb; Daniel S Evans; Xiuqing Guo; Sina A Gharib; Lauren Hale; David R Hillman; Pamela L Lutsey; Sutapa Mukherjee; Heather M Ochs-Balcom; Lyle J Palmer; Jessica Rhodes; Shaun Purcell; Sanjay R Patel; Richa Saxena; Katie L Stone; Weihong Tang; Gregory J Tranah; Eric Boerwinkle; Xihong Lin; Yongmei Liu; Bruce M Psaty; Ramachandran S Vasan; Michael H Cho; Ani Manichaikul; Edwin K Silverman; R Graham Barr; Stephen S Rich; Jerome I Rotter; James G Wilson; Susan Redline; Xiaofeng Zhu Journal: Am J Hum Genet Date: 2019-10-24 Impact factor: 11.025
Authors: Carrie P Aaron; Joseph E Schwartz; Eric A Hoffman; Elsa Angelini; John H M Austin; Mary Cushman; David R Jacobs; Joel D Kaufman; Andrew Laine; Lewis J Smith; Jie Yang; Karol E Watson; Russell P Tracy; R Graham Barr Journal: Chest Date: 2017-12-12 Impact factor: 9.410
Authors: Prashant Nagpal; Junfeng Guo; Kyung Min Shin; Jae-Kwang Lim; Ki Beom Kim; Alejandro P Comellas; David W Kaczka; Samuel Peterson; Chang Hyun Lee; Eric A Hoffman Journal: BJR Open Date: 2021-01-22