Increased body mass index is related to apparent circumscribed pleural thickening on plain chest radiographs.
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.
Lee
Y C
YC
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia. ycgarylee@hotmail.com
Runnion
C K
CK
Pang
S C
SC
de Klerk
N H
NH
Musk
A W
AW
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