scholarly journals 4088 Longitudinal Assessment of Metabolic Syndrome as a Modifiable Risk factor of World Trade Center Particulate Matter Exposure Associated Lung Disease

2020 ◽  
Vol 4 (s1) ◽  
pp. 49-50
Author(s):  
Sophia Kwon ◽  
Myeonggyun Lee ◽  
Theresa Schwartz ◽  
Rachel Zeig-Owens ◽  
David Prezant ◽  
...  

OBJECTIVES/GOALS: Metabolic syndrome (MetSyn) is a risk for World Trade Center-Lung Injury (WTC-LI; defined as developing FEV1<lower limit of normal [LLN]). Metabolic health is a modifiable disease risk factor. We propose to characterize how time-dependent covariates of MetSyn are longitudinally associated with WTC-LI. METHODS/STUDY POPULATION: WTC-particulate exposed firefighters, consented, with pre-9/11 FEV1 LLN (N = 5,746). Data assessed from last pre-9/11 till August 1, 2017. Longitudinal MetSyn characteristics were assessed using 3 models: i. A linear mixed effect model to assess the effect size of longitudinal MetSyn and its components on longitudinal FEV1% predicted as an outcome; ii. a time-dependent Cox regression to assess the associations of MetSyn to time of onset of WTC-LI; iii. a novel, partially linear single index regression model with repeatedly measured MetSyn to assess their joint effects and delineate their relative contribution on the longitudinal lung function in the WTC-FDNY cohort. RESULTS/ANTICIPATED RESULTS: In Model I, BMI 30 kg/m2 had the largest effect size compared to ever-smoking, with −2.524 (95%CI: −2.708,−2.340) compared to −1.681(−2.325,−1.038) respectively. Having MetSyn, defined as 3/5 risk factors, had an effect size of −2.319(−2.526,−2.112). In Model II, hazards of triglycerides 150mg/dL were highest at 1.497(1.336, 1.677), followed by BMI 30 kg/m2 at 1.406(1.256, 1.575), and HDL<40mg/dL 1.355(1.176-1.561), compared to ever-smoking (1.201, p = 0.002). Having high exposure to PM by being present in the morning of 9/11 was a significant covariate only in Model II investigating HDL<40mg/dL or triglycerides 150mg/dL. Model III The proposed methods will be applied to our cohort study. DISCUSSION/SIGNIFICANCE OF IMPACT: MetSyn is both a predictor and concurrent marker of WTC-LI. The single index model can not only reduce dimensionality of the covariates, but also provides efficient estimates of the joint MetSyn effects, allowing linear or nonlinear effects. Future studies will investigate dietary intervention as a potential disease-modifying factor. CONFLICT OF INTEREST DESCRIPTION: NA, nothing to disclose.

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A864
Author(s):  
Sophia Kwon ◽  
George Crowley ◽  
Mena Mikhail ◽  
Rachel Lam ◽  
Emily Clementi ◽  
...  

CHEST Journal ◽  
2019 ◽  
Vol 155 (2) ◽  
pp. 375-383 ◽  
Author(s):  
Jag Sunderram ◽  
Michael Weintraub ◽  
Kathleen Black ◽  
Shahnaz Alimokhtari ◽  
Akosua Twumasi ◽  
...  

CHEST Journal ◽  
2019 ◽  
Vol 156 (3) ◽  
pp. 486-496 ◽  
Author(s):  
Sophia Kwon ◽  
George Crowley ◽  
Erin J. Caraher ◽  
Syed Hissam Haider ◽  
Rachel Lam ◽  
...  

Author(s):  
Sophia Kwon ◽  
George Crowley ◽  
Mena Mikhail ◽  
Rachel Lam ◽  
Emily Clementi ◽  
...  

Airway hyperreactivity (AHR) related to environmental exposure is a significant public health risk worldwide. Similarly, metabolic syndrome (MetSyn), a risk factor for obstructive airway disease (OAD) and systemic inflammation, is a significant contributor to global adverse health. This prospective cohort study followed N = 7486 World Trade Center (WTC)-exposed male firefighters from 11 September 2001 (9/11) until 1 August 2017 and investigated N = 539 with newly developed AHR for clinical biomarkers of MetSyn and compared them to the non-AHR group. Male firefighters with normal lung function and no AHR pre-9/11 who had blood drawn from 9 September 2001–24 July 2002 were assessed. World Trade Center-Airway Hyperreactivity (WTC-AHR) was defined as either a positive bronchodilator response (BDR) or methacholine challenge test (MCT). The electronic medical record (EMR) was queried for their MetSyn characteristics (lipid profile, body mass index (BMI), glucose), and routine clinical biomarkers (such as complete blood counts). We modeled the association of MetSyn characteristics at the first post-9/11 exam with AHR. Those with AHR were significantly more likely to be older, have higher BMIs, have high intensity exposure, and have MetSyn. Smoking history was not associated with WTC-AHR. Those present on the morning of 9/11 had 224% increased risk of developing AHR, and those who arrived in the afternoon of 9/11 had a 75.9% increased risk. Having ≥3 MetSyn parameters increased the risk of WTC-AHR by 65.4%. Co-existing MetSyn and high WTC exposure are predictive of future AHR and suggest that systemic inflammation may be a contributor.


2016 ◽  
Vol 59 (9) ◽  
pp. 752-760 ◽  
Author(s):  
Jacqueline M. Moline ◽  
Mary Ann McLaughlin ◽  
Simonette T. Sawit ◽  
Cynara Maceda ◽  
Lori B. Croft ◽  
...  

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