title: Increased body mass index is related to apparent circumscribed pleural thickening on plain chest radiographs.
abstract: BACKGROUND
  Diffuse pleural thickening and pleural plaques are the commonest radiological manifestations of asbestos exposure. Differentiation between subpleural fat and non-calcified pleural plaques is important clinically and medico-legally. This study aims to determine if apparent circumscribed pleural thickening on chest radiographs is related with obesity.
  
  
  METHODS
  Surveillance chest x-rays of 693 former asbestos workers were read with the ILO classification. Subjects with costophrenic angle obliteration (n = 57) were analyzed separately. The remaining subjects were subdivided according to their body mass index (BMI): Group 1 < 26 kg/m(2); Group 2 26-30 kg/m(2); Group 3 > 30 kg/m(2).
  
  
  RESULTS
  Baseline characteristics, asbestos exposure, and profusion scores were evenly distributed. BMI of > 30 kg/m(2) was associated with a higher prevalence of pleural thickening on CXR (Gp1 = 8.5%; Gp2 = 9.3%; Gp3 = 18.3%). This relationship was strongest in the subgroups with 25-50% of the lateral chest wall involved and pleural thickness of < 10 mm.
  
  
  CONCLUSIONS
  Obesity (BMI > 30 kg/m(2)) is related to apparent circumscribed pleural thickening on CXR, especially thin (< 1 cm) shadows covering 25-50% of the lateral chest wall.
authors.affiliation: Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia. ycgarylee@hotmail.com
authors.forename: Y C
authors.initials: YC
authors.lastname: Lee
authors.forename: C K
authors.initials: CK
authors.lastname: Runnion
authors.forename: S C
authors.initials: SC
authors.lastname: Pang
authors.forename: N H
authors.initials: NH
authors.lastname: de Klerk
authors.forename: A W
authors.initials: AW
authors.lastname: Musk
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging; D001195:Asbestosis / Q000000981:diagnostic imaging; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging*; D016273:Occupational Exposure; D010994:Pleura / Q000000981:diagnostic imaging*; D010995:Pleural Diseases / Q000000981:diagnostic imaging; D011159:Population Surveillance; D015995:Prevalence; D013902:Radiography, Thoracic; D013909:Thorax; D014904:Western Australia