@article {1048, title = {Inflammatory markers and longitudinal lung function decline in the elderly.}, journal = {Am J Epidemiol}, volume = {168}, year = {2008}, month = {2008 Sep 15}, pages = {602-10}, abstract = {

Longitudinal studies examining associations of the inflammatory markers fibrinogen and C-reactive protein (CRP) with lung function decline are sparse. The authors examined whether elevated fibrinogen and CRP levels were associated with greater longitudinal lung function decline in the elderly. The Cardiovascular Health Study measured fibrinogen and CRP in 5,790 Whites and African Americans from four US communities aged 65 years or older in 1989-1990 or 1992-1993. Spirometry was performed in 1989-1990 and 4, 7, and 16 years later. Fibrinogen and CRP were inversely associated with lung function at baseline after adjustment for multiple potential confounders. In mixed models, the rate of decline in forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) ratio with increasing age was faster among those with higher baseline fibrinogen (-0.032\%/year per standard deviation higher fibrinogen (95\% confidence interval: -0.057, -0.0074)) but not among those with higher CRP (-0.0037\%/year per standard deviation higher CRP (95\% confidence interval: -0.013, 0.0056)). Longitudinal analyses for FEV(1) and FVC yielded results in the direction opposite of that hypothesized, possibly because of the high mortality rate and strong inverse association of FEV(1) and FVC but not FEV(1)/FVC with mortality. An alternative approach to missing data yielded similar results. In conclusion, higher levels of fibrinogen, but not CRP, independently predicted greater FEV(1)/FVC decline in the elderly.

}, keywords = {Aged, C-Reactive Protein, Cross-Sectional Studies, Female, Fibrinogen, Forced Expiratory Volume, Geriatric Assessment, Humans, Logistic Models, Longitudinal Studies, Lung Volume Measurements, Male, Multicenter Studies as Topic, Pulmonary Disease, Chronic Obstructive, Spirometry}, issn = {1476-6256}, doi = {10.1093/aje/kwn174}, author = {Jiang, Rui and Burke, Gregory L and Enright, Paul L and Newman, Anne B and Margolis, Helene G and Cushman, Mary and Tracy, Russell P and Wang, Yuanjia and Kronmal, Richard A and Barr, R Graham} } @article {1411, title = {Obesity is associated with a lower resting oxygen saturation in the ambulatory elderly: results from the cardiovascular health study.}, journal = {Respir Care}, volume = {58}, year = {2013}, month = {2013 May}, pages = {831-7}, abstract = {

BACKGROUND: The contribution of obesity to hypoxemia has not been reported in a community-based study. Our hypothesis was that increasing obesity would be independently associated with lower SpO2 in an ambulatory elderly population.

METHODS: The Cardiovascular Health Study ascertained resting SpO2 in 2,252 subjects over age 64. We used multiple linear regression to estimate the association of body mass index (BMI) with SpO2 and to adjust for potentially confounding factors. Covariates including age, sex, race, smoking, airway obstruction (based on spirometry), self reported diagnosis of emphysema, asthma, heart failure, and left ventricular function (by echocardiography) were evaluated.

RESULTS: Among 2,252 subjects the mean and median SpO2 were 97.6\% and 98.0\% respectively; 5\% of subjects had SpO2 values below 95\%. BMI was negatively correlated with SpO2 (Spearman R = -0.27, P < .001). The mean difference in SpO2 between the lowest and highest BMI categories (< 25 kg/m(2) and >= 35 kg/m(2)) was 1.33\% (95\% CI 0.89-1.78\%). In multivariable linear regression analysis, SpO2 was significantly inversely associated with BMI (1.4\% per 10 units of BMI, 95\% CI 1.2-1.6, for whites/others, and 0.87\% per 10 units of BMI, 95\% CI 0.47-1.27, for African Americans).

CONCLUSIONS: We found a narrow distribution of SpO2 values in a community-based sample of ambulatory elderly. Obesity was a strong independent contributor to a low SpO2, with effects comparable to or greater than other factors clinically associated with lower SpO2.

}, keywords = {African Americans, Age Factors, Aged, Aged, 80 and over, Body Mass Index, European Continental Ancestry Group, Female, Humans, Male, Obesity, Oximetry, Oxygen, Smoking, Waist Circumference}, issn = {1943-3654}, doi = {10.4187/respcare.02008}, author = {Kapur, Vishesh K and Wilsdon, Anthony G and Au, David and Avdalovic, Mark and Enright, Paul and Fan, Vincent S and Hansel, Nadia N and Heckbert, Susan R and Jiang, Rui and Krishnan, Jerry A and Mukamal, Kenneth and Yende, Sachin and Barr, R Graham} }