title: Metabolic syndrome biomarkers predict lung function impairment: a nested case-control study.
abstract: BACKGROUND
  Cross-sectional studies demonstrate an association between metabolic syndrome and impaired lung function.
  
  
  OBJECTIVE
  To define if metabolic syndrome biomarkers are risk factors for loss of lung function after irritant exposure.
  
  
  METHODS
  A nested case-control study of Fire Department of New York personnel with normal pre-September 11th FEV(1) and who presented for subspecialty pulmonary evaluation before March 10, 2008. We correlated metabolic syndrome biomarkers obtained within 6 months of World Trade Center dust exposure with subsequent FEV(1). FEV(1) at subspecialty pulmonary evaluation within 6.5 years defined disease status; cases had FEV(1) less than lower limit of normal, whereas control subjects had FEV(1) greater than or equal to lower limit of normal.
  
  
  RESULTS
  Clinical data and serum sampled at the first monitoring examination within 6 months of September 11, 2001, assessed body mass index, heart rate, serum glucose, triglycerides and high-density lipoprotein (HDL), leptin, pancreatic polypeptide, and amylin. Cases and control subjects had significant differences in HDL less than 40 mg/dl with triglycerides greater than or equal to 150 mg/dl, heart rate greater than or equal to 66 bpm, and leptin greater than or equal to 10,300 pg/ml. Each increased the odds of abnormal FEV(1) at pulmonary evaluation by more than twofold, whereas amylin greater than or equal to 116 pg/ml decreased the odds by 84%, in a multibiomarker model adjusting for age, race, body mass index, and World Trade Center arrival time. This model had a sensitivity of 41%, a specificity of 86%, and a receiver operating characteristic area under the curve of 0.77.
  
  
  CONCLUSIONS
  Abnormal triglycerides and HDL and elevated heart rate and leptin are independent risk factors of greater susceptibility to lung function impairment after September 11, 2001, whereas elevated amylin is protective. Metabolic biomarkers are predictors of lung disease, and may be useful for assessing risk of impaired lung function in response to particulate inhalation.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
authors.forename: Bushra
authors.initials: B
authors.lastname: Naveed
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiden
authors.forename: Sophia
authors.initials: S
authors.lastname: Kwon
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Gracely
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Comfort
authors.forename: Natalia
authors.initials: N
authors.lastname: Ferrier
authors.forename: Kusali J
authors.initials: KJ
authors.lastname: Kasturiarachchi
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Aldrich
authors.forename: William N
authors.initials: WN
authors.lastname: Rom
authors.forename: Kerry
authors.initials: K
authors.lastname: Kelly
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
authors.forename: Anna
authors.initials: A
authors.lastname: Nolan
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D004391:Dust; D061388:Firefighters; D005541:Forced Expiratory Volume; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D009519:New York City; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012680:Sensitivity and Specificity; D047851:September 11 Terrorist Attacks; D013147:Spirometry
chemical_list: D000395:Air Pollutants, Occupational; D015415:Biomarkers; D004391:Dust
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