Rationale: Although interstitial lung abnormalities (ILA), specific patterns of incidentally-detected abnormal density on computed tomography, have been associated with abnormal lung function and increased mortality, it is unclear if a subset with incidental interstitial lung disease (ILD) accounts for these adverse consequences. Objectives: To define the prevalence and risk factors of suspected ILD and assess outcomes. Methods: Suspected ILD was evaluated in the COPDGene (Chronic Obstructive Pulmonary Disease Genetic Epidemiology) study, defined as ILA and at least one additional criterion: definite fibrosis on computed tomography, FVC less than 80% predicted, or DLCO less than 70% predicted. Multivariable linear, longitudinal, and Cox proportional hazards regression models were used to assess associations with St. George's Respiratory Questionnaire, 6-minute-walk test, supplemental oxygen use, respiratory exacerbations, and mortality. Measurements and Main Results: Of 4,361 participants with available data, 239 (5%) had evidence for suspected ILD, whereas 204 (5%) had ILA without suspected ILD. In multivariable analyses, suspected ILD was associated with increased St. George's Respiratory Questionnaire score (mean difference [MD], 3.9 points; 95% confidence interval [CI], 0.6-7.1; P = 0.02), reduced 6-minute-walk test (MD, -35 m; 95% CI, -56 m to -13 m; P = 0.002), greater supplemental oxygen use (odds ratio [OR], 2.3; 95% CI, 1.1-5.1; P = 0.03) and severe respiratory exacerbations (OR, 2.9; 95% CI, 1.1-7.5; P = 0.03), and higher mortality (hazard ratio, 2.4; 95% CI, 1.2-4.6; P = 0.01) compared with ILA without suspected ILD. Risk factors associated with suspected ILD included self-identified Black race (OR, 2.0; 95% CI, 1.1-3.3; P = 0.01) and pack-years smoking history (OR, 1.2; 95% CI, 1.1-1.3; P = 0.0005). Conclusions: Suspected ILD is present in half of those with ILA in COPDGene and is associated with exercise decrements and increased symptoms, supplemental oxygen use, severe respiratory exacerbations, and mortality.

中文翻译：

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COPD基因研究中疑似间质性肺疾病。


理由：尽管间质性肺异常 (ILA)（计算机断层扫描中偶然检测到的异常密度的特定模式）与肺功能异常和死亡率增加相关，但尚不清楚偶然间质性肺疾病 (ILD) 的子集是否能解释这些异常不良后果。目标：确定疑似 ILD 的患病率和危险因素并评估结果。方法：在 COPDGene（慢性阻塞性肺疾病遗传流行病学）研究中对疑似 ILD 进行评估，定义为 ILA 和至少一项附加标准：计算机断层扫描明确纤维化、FVC 低于预测值 80%，或 DLCO 低于预测值 70%。使用多变量线性、纵向和 Cox 比例风险回归模型来评估与圣乔治呼吸问卷、6 分钟步行测试、补充氧气使用、呼吸加重和死亡率的关联。测量和主要结果：在拥有可用数据的 4,361 名参与者中，239 名（5%）有疑似 ILD 的证据，而 204 名（5%）有 ILA，但没有疑似 ILD。在多变量分析中，疑似 ILD 与圣乔治呼吸问卷评分增加（平均差 [MD]，3.9 分；95% 置信区间 [CI]，0.6-7.1；P = 0.02）、减少 6 分钟步行测试相关（MD，-35 m；95% CI，-56 m 至 -13 m；P = 0.002），更多的补充氧气使用（比值比 [OR]，2.3；95% CI，1.1-5.1；P = 0.03）和与无疑似 ILD 的 ILA 相比，严重呼吸系统恶化（OR，2.9；95% CI，1.1-7.5；P = 0.03）和更高的死亡率（风险比，2.4；95% CI，1.2-4.6；P = 0.01）。与疑似 ILD 相关的危险因素包括自我认定的黑人种族（OR，2.0；95% CI，1.1-3.3；P = 0。01）和包年吸烟史（OR，1.2；95% CI，1.1-1.3；P = 0.0005）。结论：COPDGene 中一半的 ILA 患者疑似 ILD，并且与运动量减少、症状增加、补充氧气使用、严重呼吸系统恶化和死亡率相关。