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Endothelial dysfunction is associated with impaired lung function

in two independent community cohorts.

Respir Med. 2018 Oct;143:123-128. doi: 10.1016/j.rmed.2018.09.009. Epub 2018 Sep 12.

Endothelial dysfunction is associated with impaired lung function in two independent community cohorts.

Rydell A1, Janson C2, Lisspers K3, Ställberg B3, Nowak C4, Carlsson AC5, Feldreich T6, Iggman D7, Lind L8, Ärnlöv J9.

Author information 1Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Dalarna County Council, Norslund-Svärdsjö Primary Health Care Center, Falun, Sweden.2Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.3Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.4Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden.5Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.6School of Health and Social Sciences, Dalarna University, Falun, Sweden; Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.7Dalarna County Council, Norslund-Svärdsjö Primary Health Care Center, Falun, Sweden; Unit for Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.8Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.9Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden; Dalarna County Council, Norslund-Svärdsjö Primary Health Care Center, Falun, Sweden; School of Health and Social Sciences, Dalarna University, Falun, Sweden. Electronic address: johan.arnlov@ki.se.

Abstract BACKGROUND: Prior studies investigating the association between endothelial dysfunction and impaired lung function have been small and inconsistent. The primary aim was to investigate the association between endothelial function and lung function in two community-based cohorts. METHODS: We used a discovery/replication approach to study the association between endothelial function and lung function in the Prospective investigation of Obesity, Energy and Metabolism (POEM, discovery cohort, n = 490, mean age 50.3 ± 0.2 years) and the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS, replication cohort, n = 892, mean age 70.2 ± 0.15 years). Spirometry and three different measures of endothelial function were performed including both the invasive forearm technique (endothelium-dependent and endothelium-independent vasodilation [EDV and EIDV, respectively] and noninvasive flow mediated dilation [FMD]). RESULTS: An age and sex adjusted association between lower EDV and lower FEV1 was found in POEM and replicated in PIVUS. After merging the two cohorts, 1 standard deviation decrease in EDV was associated with 1.57% lower FEV1 after additional adjustment for smoking status, body mass index, exercise level, and C-reactive protein (95% confidence intervals 0.63-2.51, p = 0.001). The association was slightly lower albeit still statistically significant after excluding participants without cardiovascular disease and chronic respiratory disease and appeared stronger among previous/current smokers vs. non-smokers and in men vs. women (p for interaction = 0.2 and 0.02 respectively). CONCLUSIONS: Our findings suggest that even individuals with sub-clinical impairments of lung function in the community have concomitant endothelial dysfunction. Copyright © 2018. Published by Elsevier Ltd.