Abstract
Background Serum lipoproteins, such as high-density lipoproteins (HDL), may influence disease severity in idiopathic pulmonary fibrosis (IPF). Here, we investigated associations between serum lipids and lipoproteins and clinical end-points in IPF.
Methods Clinical data and serum lipids were analysed from a discovery cohort (59 IPF subjects, 56 healthy volunteers) and validated using an independent, multicentre cohort (207 IPF subjects) from the Pulmonary Fibrosis Foundation registry. Associations between lipids and clinical end-points (forced vital capacity, 6-min walk distance, gender age physiology (GAP) index, death or lung transplantation) were examined using Pearson's correlation and multivariable analyses.
Results Serum concentrations of small HDL particles measured using nuclear magnetic resonance spectroscopy (S-HDLPNMR) correlated negatively with the GAP index in the discovery cohort of IPF subjects. The negative correlation of S-HDLPNMR with GAP index was confirmed in the validation cohort of IPF subjects. Higher levels of S-HDLPNMR were associated with lower odds of death or its competing outcome, lung transplantation (OR 0.9 for each 1-μmol·L−1 increase in S-HDLPNMR, p<0.05), at 1, 2 and 3 years from study entry in a combined cohort of all IPF subjects.
Conclusions Higher serum levels of S-HDLPNMR are negatively correlated with the GAP index, as well as with lower observed mortality or lung transplantation in IPF subjects. These findings support the hypothesis that S-HDLPNMR may modify mortality risk in patients with IPF.
Abstract
This is the first study showing that higher serum levels of small HDL particles correlate with a lower risk of death or lung transplantation in patients with idiopathic pulmonary fibrosis, suggesting that they may be important in IPF pathobiology https://bit.ly/2RG4UGS
Footnotes
This article has supplementary material available from erj.ersjournals.com
An abstract reporting preliminary results was presented at the 2018 International American Thoracic Society meeting in San Diego, CA, USA (20 May 2018, Session A21: clinical and mechanistic studies of lung fibrosis; poster 912).
Author contributions: A.V. Barochia, N. Weir, M. Kaler, A.T. Remaley, G. Grant, S.D. Nathan and S.J. Levine conceived the study; A.V. Barochia, M. Kaler, N. Weir and M. Lemma WoldeHanna collected the data; A.V. Barochia, E.M. Gordon, D.M. Figueroa, X. Yao and M. Sampson performed the assays; A.V. Barochia, S.D. Barnett, N. Weir, S.D. Nathan, G. Grant, A.T. Remaley and S.J. Levine analysed the data; A.V. Barochia and S.J. Levine wrote the manuscript. All authors provided critical review of the manuscript and approved of its contents and submission. A.V. Barochia takes responsibility for the content of the manuscript, including the data and analysis.
Conflict of interest: A.V. Barochia has nothing to disclose.
Conflict of interest: M. Kaler has nothing to disclose.
Conflict of interest: N. Weir has nothing to disclose.
Conflict of interest: E.M. Gordon has nothing to disclose.
Conflict of interest: D.M. Figueroa has nothing to disclose.
Conflict of interest: X. Yao has nothing to disclose.
Conflict of interest: M. Lemma WoldeHanna has nothing to disclose.
Conflict of interest: M. Sampson has nothing to disclose.
Conflict of interest: A.T. Remaley has nothing to disclose.
Conflict of interest: G. Grant has nothing to disclose.
Conflict of interest: S.D. Barnett has nothing to disclose.
Conflict of interest: S.D. Nathan is a consultant and is on the speakers’ bureau for Roche-Genentech and Boehringer Ingelheim, and has received research funding from both companies.
Conflict of interest: S.J. Levine has nothing to disclose.
Support statement: This work was funded by the Division of Intramural Research at the National Heart, Lung, and Blood Institute (NIH, Bethesda, MD, USA). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received November 3, 2020.
- Accepted April 13, 2021.
- The content of this work is not subject to copyright. Design and branding are copyright ©ERS 2021. For commercial reproduction rights and permissions contact permissions{at}ersnet.org
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