TY - JOUR T1 - High attenuation areas on chest computed tomography in community-dwelling adults: the MESA study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00129-2016 SP - ERJ-00129-2016 AU - Anna J. Podolanczuk AU - Elizabeth C. Oelsner AU - R. Graham Barr AU - Eric A. Hoffman AU - Hilary F. Armstrong AU - John H. M. Austin AU - Robert C. Basner AU - Matthew N. Bartels AU - Jason D. Christie AU - Paul L. Enright AU - Bernadette R. Gochuico AU - Karen Hinckley Stukovsky AU - Joel D. Kaufman AU - P. Hrudaya Nath AU - John D. Newell, Jr AU - Scott M. Palmer AU - Dan Rabinowitz AU - Ganesh Raghu AU - Jessica L. Sell AU - Jered Sieren AU - Sushil K. Sonavane AU - Russell P. Tracy AU - Jubal R. Watts AU - Kayleen Williams AU - Steven M. Kawut AU - David J. Lederer Y1 - 2016/07/28 UR - http://erj.ersjournals.com/content/early/2016/07/28/13993003.00129-2016.abstract N2 - Evidence suggests that lung injury, inflammation and extracellular matrix remodelling precede lung fibrosis in interstitial lung disease (ILD). We examined whether a quantitative measure of increased lung attenuation on computed tomography (CT) detects lung injury, inflammation and extracellular matrix remodelling in community-dwelling adults sampled without regard to respiratory symptoms or smoking.We measured high attenuation areas (HAA; percentage of lung voxels between −600 and −250 Hounsfield Units) on cardiac CT scans of adults enrolled in the Multi-Ethnic Study of Atherosclerosis.HAA was associated with higher serum matrix metalloproteinase-7 (mean adjusted difference 6.3% per HAA doubling, 95% CI 1.3–11.5), higher interleukin-6 (mean adjusted difference 8.8%, 95% CI 4.8–13.0), lower forced vital capacity (FVC) (mean adjusted difference −82 mL, 95% CI −119–−44), lower 6-min walk distance (mean adjusted difference −40 m, 95% CI −1–−80), higher odds of interstitial lung abnormalities at 9.5 years (adjusted OR 1.95, 95% CI 1.43–2.65), and higher all cause-mortality rate over 12.2 years (HR 1.58, 95% CI 1.39–1.79).High attenuation areas are associated with biomarkers of inflammation and extracellular matrix remodelling, reduced lung function, interstitial lung abnormalities, and a higher risk of death among community-dwelling adults.Increased lung attenuation on CT may identify subclinical lung injury and inflammation in community-dwelling adults http://ow.ly/97k3300tvKX ER -