title: Obesity as a susceptibility factor to indoor particulate matter health effects in COPD.
abstract: Our goal was to investigate whether obesity increases susceptibility to the adverse effects of indoor particulate matter on respiratory morbidity among individuals with chronic obstructive pulmonary disease (COPD). Participants with COPD were studied at baseline, 3 and 6 months. Obesity was defined as a body mass index ≥30 kg·m(-2). At each time point, indoor air was sampled for 5-7 days and particulate matter (PM) with an aerodynamic size ≤2.5 μm (PM2.5) and 2.5-10 μm (PM2.5-10) was measured. Respiratory symptoms, health status, rescue medication use, exacerbations, blood biomarkers and exhaled nitric oxide were assessed simultaneously. Of the 84 participants enrolled, 56% were obese and all were former smokers with moderate-to-severe COPD. Obese participants tended to have less severe disease as assessed by Global Initiative for Chronic Obstructive Pulmonary Disease stage and fewer pack-years of smoking. There was evidence that obesity modified the effects of indoor PM on COPD respiratory outcomes. Increases in PM2.5 and PM2.5-10 were associated with greater increases in nocturnal symptoms, dyspnoea and rescue medication use among obese versus non-obese participants. The impact of indoor PM on exacerbations, respiratory status and wheeze also tended to be greater among obese versus non-obese participants, as were differences in airway and systemic inflammatory responses to indoor PM. We found evidence that obesity was associated with exaggerated responses to indoor fine and coarse PM exposure among individuals with COPD.
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA Dept of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Mmccor16@jhmi.edu.
authors.forename: Meredith C
authors.initials: MC
authors.lastname: McCormack
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Belli
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Deepak A
authors.initials: DA
authors.lastname: Kaji
authors.affiliation: Dept of Pediatrics, Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Matsui
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Emily P
authors.initials: EP
authors.lastname: Brigham
authors.affiliation: Dept of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Roger D
authors.initials: RD
authors.lastname: Peng
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Cortlandt
authors.initials: C
authors.lastname: Sellers
authors.affiliation: Dept of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: D'Ann L
authors.initials: DL
authors.lastname: Williams
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA Dept of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Diette
authors.affiliation: Dept of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Breysse
authors.affiliation: Dept of Medicine, Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA Dept of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Nadia N
authors.initials: NN
authors.lastname: Hansel
mesh_terms: D000368:Aged; D000393:Air Pollutants; D016902:Air Pollution, Indoor / Q000032:analysis*; D015415:Biomarkers / Q000097:blood; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D004198:Disease Susceptibility; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking; D013147:Spirometry
chemical_list: D000393:Air Pollutants; D015415:Biomarkers; D052638:Particulate Matter