%0 Journal Article %A Anna J. Podolanczuk %A Elizabeth C. Oelsner %A R. Graham Barr %A Eric A. Hoffman %A Hilary F. Armstrong %A John H. M. Austin %A Robert C. Basner %A Matthew N. Bartels %A Jason D. Christie %A Paul L. Enright %A Bernadette R. Gochuico %A Karen Hinckley Stukovsky %A Joel D. Kaufman %A P. Hrudaya Nath %A John D. Newell, Jr %A Scott M. Palmer %A Dan Rabinowitz %A Ganesh Raghu %A Jessica L. Sell %A Jered Sieren %A Sushil K. Sonavane %A Russell P. Tracy %A Jubal R. Watts %A Kayleen Williams %A Steven M. Kawut %A David J. Lederer %T High attenuation areas on chest computed tomography in community-dwelling adults: the MESA study %D 2016 %R 10.1183/13993003.00129-2016 %J European Respiratory Journal %P ERJ-00129-2016 %X 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 %U https://erj.ersjournals.com/content/erj/early/2016/07/28/13993003.00129-2016.full.pdf