scholarly journals Predictors of impaired pulmonary function in people living with HIV in an urban African setting

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sarah E. Van Riel ◽  
Kerstin Klipstein-Grobusch ◽  
Roos E. Barth ◽  
Diederick E. Grobbee ◽  
Charles Feldman ◽  
...  

Background: Studies have associated HIV with an increased risk of obstructive lung disease (OLD).Objectives: We aimed to identify the predictive factors for impaired lung function in an urban, African, HIV-positive population.Method: A cross-sectional study was performed in Johannesburg, South Africa, from July 2016 to November 2017. A questionnaire was administered and pre- and post-bronchodilator spirometry conducted. The predictors investigated included age, sex, antiretroviral treatment (ART) duration, body mass index, history of tuberculosis (TB) or pneumonia, occupational exposure, environmental exposure, smoking and symptoms of OLD (cough, wheeze, mucus and dyspnoea). Impaired lung function was defined as a forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio of 0.70, or below the 20th percentile of normal.Results: The 98 ART-naïve participants (mean age = 34.0, standard deviation [s.d.] = 8.2), 85 participants on first-line ART (mean age = 36.9, s.d. = 6.6) and 189 participants on second-line ART (mean age = 43.5, s.d. = 7.9) were predominantly female (65.6%). Of the participants, 64 (17.2%) had impaired lung function and 308 had normal lung function. Linear regression identified age (β = –0.003, P 0.01), male sex (β = –0.016, P = 0.03) and history of TB or pneumonia (β = –0.024, P 0.01) as independent predictors of a lower FEV1/FVC ratio. Following logistic regression, only a history of TB or pneumonia (odds ratio = 2.58, 95% confidence interval = 1.47–4.52) was significantly related to impaired lung function (area under the receiver operating characteristic curve = 0.64).Conclusion: Our data show that a history of TB or pneumonia predicts impaired lung function. In order to improve timely access to spirometry, clinicians should be alert to the possibility of impaired lung function in people with a history of TB or pneumonia.


2014 ◽  
Vol 5 ◽  
pp. JCM.S13564 ◽  
Author(s):  
Yayoi Yamamoto ◽  
Junko Oya ◽  
Tomoko Nakagami ◽  
Yasuko Uchigata

Purpose We examined the cross-sectional association between lung function and metabolic syndrome (MetS), independent of fasting immunoreactive insulin (F-IRI). Methods A total of 3,072 middle-aged, apparently healthy subjects who participated in a general health check-up were included. Lung function, which was expressed as forced vital capacity (%FVC predicted) or forced expiratory volume in 1 second (FEV1% predicted) was examined. Multivariable logistic regression analysis was performed to assess the association between lung function and MetS. Results Men with the lowest quartile of FVC% predicted, or those with the lowest quartile of FEV1% predicted, had a 3.5-fold or 2.6-fold increased risk of MetS, respectively, compared with those with the highest quartile of FVC% predicted or FEV1% predicted. F-IRI had a positive, significant, and independent association with MetS in both sexes. Conclusion Impaired lung function increased the risk of MetS, independent of F-IRI and smoking in men, but not in women.



2020 ◽  
Vol 18 (6) ◽  
pp. 388-395
Author(s):  
Daniel Vargas-Pacherrez ◽  
Helma P. Cotrim ◽  
Leonardo Pires ◽  
Vitor Cunha ◽  
Vitor Coelho ◽  
...  

Introduction: The global prevalence of metabolic syndrome (MS) among people living with HIV/AIDS varies from 20% to 33%. Objective: to estimate the prevalence of metabolic syndrome and associated factors in a group of HIV-infected patients on antiretroviral therapy. Methods: This is a cross-sectional study with HIV-infected patients from a reference center in Bahia, Brazil. We evaluated clinical, socio-demographic and anthropometric data. MS was defined according to the guidelines of International Diabetes Federation. Results: We evaluated 152 patients with mean age of 47.3±11.6 years, 59.2% male. The main comorbidities detected were diabetes (3.3%) hypertriglyceridemia (9.3%) and metabolic syndrome (MS,38.2%). Patients with MS were predominantly women (55.2% vs 31.9%; p=0.005), older [52.1 (10.4) vs 44.3 (11.3); p<0.001], and had overweight (74.1% vs 23.4%; p<0.001). After multivariate analysis MS remained associated with age (OR = 1.076; 95% CI: 1.030 – 1.125), female sex (OR = 2.452; 95% CI: 1.114 – 5.374) and family history of hypertension (OR = 3.678; 95% CI: 1.431 – 9.395). Conclusion: Almost half of the HIV-infected patients in Bahia presents with MS which seems to be driven by classical risk factors.



Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215866
Author(s):  
Ana I Hernandez Cordero ◽  
Chen Xi Yang ◽  
Maen Obeidat ◽  
Julia Yang ◽  
Julie MacIsaac ◽  
...  

IntroductionPeople living with HIV (PLWH) suffer from age-related comorbidities such as COPD. The processes responsible for reduced lung function in PLWH are largely unknown. We performed an epigenome-wide association study to investigate whether blood DNA methylation is associated with impaired lung function in PLWH.MethodsUsing blood DNA methylation profiles from 161 PLWH, we tested the effect of methylation on FEV1, FEV1/FVC ratio and FEV1 decline over a median of 5 years. We evaluated the global methylation of PLWH with airflow obstruction by testing the differential methylation of transposable elements Alu and LINE-1, a well-described marker of epigenetic ageing.ResultsAirflow obstruction as defined by a FEV1/FVC<0.70 was associated with 1393 differentially methylated positions (DMPs), while 4676 were associated with airflow obstruction based on the FEV1/FVC<lower limit of normal. These DMPs were enriched for biological pathways associated with chronic viral infections. The airflow obstruction group was globally hypomethylated compared with those without airflow obstruction. 103 and 7112 DMPs were associated with FEV1 and FEV1/FVC, respectively. No positions were associated with FEV1 decline.ConclusionA large number of DMPs were associated with airflow obstruction and lung function in a unique cohort of PLWH. Airflow obstruction in even relatively young PLWH is associated with global hypomethylation, suggesting advanced epigenetic ageing compared with those with normal lung function. The disturbance of the epigenetic regulation of key genes not previously identified in non-HIV COPD cohorts could explain the unique risk of COPD in PLWH.



Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers



2018 ◽  
Vol 25 (02) ◽  
pp. 237-241
Author(s):  
Shabana Rafiq ◽  
Razia Bibi ◽  
Samina Ashraf

Objectives: To determine the frequency of ovarian malignancy in women ofreproductive age presenting with ovarian mass and to determine frequency of factors leadingto ovarian malignancy. Study Design: Cross sectional study. Setting: Department of Obstetrics& Gynaecology, Lady Wallington Hospital, Lahore. Period with Dates: From 05.11.11 to26.06.12. Results: The result of our study reveals majority of the patients between 21-30 yearsi.e. 45.88%(n=39), common age was 24.21+3.76 years, 43.53%(n=37) were nulliparous (inmajority), while frequency of ovarian malignancy in women of reproductive age presenting withovarian mass was recorded in 14.11%(n=12) while frequency of factors leading to ovarianmalignancy was 91.67%(n=11) patients were nulliparous while family history of ovarianmalignancy was in 8.33%(n=1) patients. Conclusions: The frequency of ovarian malignancy ishigher among reproductive age females with increased risk of nulliparity.



Neurology ◽  
2018 ◽  
Vol 91 (3) ◽  
pp. e202-e207 ◽  
Author(s):  
Jordan L. Schultz ◽  
Annie Killoran ◽  
Peg C. Nopoulos ◽  
Chloe C. Chabal ◽  
David J. Moser ◽  
...  

ObjectiveTo determine whether tetrabenazine (TBZ) use is associated with an increased incidence of depression and/or suicidal ideation.MethodsIn this retrospective cross-sectional study of the Enroll-HD database, we used multiple logistic regression analyses to determine whether TBZ use is associated with an increased incidence of depression and/or suicidal ideation. For both dependent variables (depression and suicidality), separate analyses were conducted on (1) all participants, (2) only participants with a history of depression, and (3) only participants with no history of depression. Adjustments were made for CAG repeat length, total motor score, total functional capacity, Symbol Digit Modalities Test score, sex, disease duration, history of depression (when applicable), antipsychotic use, and antidepressant use.ResultsCompared to participants who were not using TBZ (n = 3,548), TBZ users (n = 543) did not have an increased risk of depression (odds ratio [OR] = 0.78, p = 0.064). Participants taking TBZ actually had a relatively lower risk of suicidality (OR = 0.61, p = 0.043). Among only participants with a history of depression, those using TBZ had a lower incidence of depression (OR = 0.71, p = 0.016) and suicidal ideation (OR = 0.57, p = 0.028) compared to those not using TBZ. Finally, among only participants with no history of depression, TBZ use was not associated with a higher incidence of depression (OR = 1.59, p = 0.18) or suicidality (OR = 1.43, p = 0.66) compared to those who were not using TBZ.ConclusionsTBZ use was not associated with an increased incidence of depression or suicidality. These findings suggest that TBZ may be safe to use in patients with Huntington disease who have a history of depression.



BMJ Open ◽  
2019 ◽  
Vol 9 (Suppl 3) ◽  
pp. 53-62 ◽  
Author(s):  
Liam Welsh ◽  
Gayan Kathriachchige ◽  
Tahmeed Raheem ◽  
Anneke C Grobler ◽  
Melissa Wake ◽  
...  

ObjectivesTo describe the epidemiology of lung function in Australian children aged 11–12 years and their parents, and explore the degree of intergenerational concordance.DesignCross-sectional study (the Child Health CheckPoint) nested in the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven Australian cities and eight regional towns, February 2015 to March 2016. Families unable to attend a clinic appointment were offered a home visit during the same period.Participants1874 families (53% of all eligible) participated in the study. Lung function data were available for 1759 children aged 11–12 years and 1774 parents (1668 biological pairs).Outcome measuresParticipants completed spirometry with measures including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid expiratory flow (MEF), converted to z-scores using Global Lung Initiative equations. Parent–child concordance was assessed using Pearson’s correlation coefficients and multivariable linear regression models. Survey weights and methods accounted for LSAC’s complex sampling, stratification and clustering within postcodes.ResultsAll lung function measures followed approximately normal distributions. Mean (SD) for FEV1, FVC and MEF z-scores in children were 0.33 (1.07), 0.83 (1.14) and −0.48 (1.09), respectively. Mean (SD) in parents were 0.28 (1.10), 0.85 (1.15) and −0.45 (1.10), respectively. Parent FEV1, FVC and MEF were associated with child lung function with significant positive correlation coefficients (0.22, 95% CI 0.17 to 0.26; 0.24, 95% CI 0.20 to 0.29; and 0.24, 95% CI 0.20 to 0.29, respectively).ConclusionsMean lung volumes were larger but with smaller airway size than international standards for both parents and children in this population sample. Modest associations between parent and child lung function highlight the potential for better identification of ‘at risk’ populations. Therefore, these findings may aid the development of health policy that aims to prevent the onset or limit the progression of lung disease.



BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022638 ◽  
Author(s):  
Maciej Polak ◽  
Krystyna Szafraniec ◽  
Magdalena Kozela ◽  
Renata Wolfshaut-Wolak ◽  
Martin Bobak ◽  
...  

ObjectivePrevious studies have reported inverse associations between socioeconomic status (SES) and lung function, but less is known about whether pulmonary function is affected by SES changes. We aimed to describe the relationship of changes of SES between childhood and adulthood with pulmonary function.DesignCross-sectional study.ParticipantsThe study sample included 4104 men and women, aged 45–69 years, residents of Krakow, participating in the Polish part of the Health, Alcohol and Psychosocial Factors in Eastern Europe Project.Main outcomeForced expiratory volume (FEV1) and forced vital capacity (FVC) were assessed by the standardised spirometry procedure. Participants were classified into three categories of SES (low, moderate or high) based on information on parent’s education, housing standard during childhood, own education, employment status, household amenities and financial status.ResultsThe adjusted difference in mean FVC between persons with low and high adulthood SES was 100 mL (p=0.005) in men and 100 mL (p<0.001) in women; the differences in mean FEV1were 103 mL (p<0.001) and 80 mL (p<0.001), respectively. Upward social mobility and moderate or high SES at both childhood and adulthood were related to significantly higher FEV1and FVC compared with low SES at both childhood and adulthood or downward social mobility.ConclusionsLow SES over a life course was associated with the lowest lung function. Downward social mobility was associated with a poorer pulmonary function, while upward mobility or life course and moderate or high SES were associated with a better pulmonary function.



2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xin Wang ◽  
Lin-Feng Li ◽  
Da-yu Zhao ◽  
Yi-wei Shen

Background. The epidemiology of atopic dermatitis (AD) in Chinese outpatients is yet to be clarified.Objectives. To investigate population-based prevalence and clinical features of AD in Chinese outpatients.Methods. A multicenter cross-sectional study was conducted in outpatients with eczema or dermatitis from 39 tertiary hospitals in 15 provinces.Results. This study included 682 patients diagnosed with AD, with the mean age of28.8±20.1years and the median course of5.3±6.9years. AD patients had more severe itching (30.4% versus 13.8%,p<0.001) and clinically suspected bacterial infection (21.7% versus 16.1%,p<0.001) than those of other types of dermatitis. Older patients were more susceptible to have a history of flexion dermatitis (p<0.001), bacterial infection (p=0.005), and severe itching (p<0.001). Outpatients with clinically suspected bacterial infection had 3.53-fold increased risk of AD than those without it (p<0.001). The morbidity rate of AD in the (20–25°N) region is 2.86 times higher than that in the (40–45°N) region [OR (95% CI): 0.352 (0.241–0.514),p<0.001].Conclusions. AD is characterized by unique clinical/demographic features. Bacterial infection and latitude region may have an impact on the incidence of AD in China.



2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Rodolfo J Dennis ◽  
Dario Maldonado ◽  
Maria X Rojas ◽  
Pablo Aschner ◽  
Martin Rondón ◽  
...  


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