RT Journal Article SR Electronic T1 High attenuation areas on chest computed tomography in community-dwelling adults: the MESA study JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP ERJ-00129-2016 DO 10.1183/13993003.00129-2016 A1 Anna J. Podolanczuk A1 Elizabeth C. Oelsner A1 R. Graham Barr A1 Eric A. Hoffman A1 Hilary F. Armstrong A1 John H. M. Austin A1 Robert C. Basner A1 Matthew N. Bartels A1 Jason D. Christie A1 Paul L. Enright A1 Bernadette R. Gochuico A1 Karen Hinckley Stukovsky A1 Joel D. Kaufman A1 P. Hrudaya Nath A1 John D. Newell, Jr A1 Scott M. Palmer A1 Dan Rabinowitz A1 Ganesh Raghu A1 Jessica L. Sell A1 Jered Sieren A1 Sushil K. Sonavane A1 Russell P. Tracy A1 Jubal R. Watts A1 Kayleen Williams A1 Steven M. Kawut A1 David J. Lederer YR 2016 UL http://erj.ersjournals.com/content/early/2016/07/28/13993003.00129-2016.abstract AB 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