Independent Association Between Occupational Exposure and Decline of FVC in Systemic Sclerosis: A Multicenter Recruitment Retrospective Cohort Study.
FVC variation
occupational exposure
sex
systemic sclerosis
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
25
05
2021
revised:
22
10
2021
accepted:
03
11
2021
pubmed:
19
11
2021
medline:
13
4
2022
entrez:
18
11
2021
Statut:
ppublish
Résumé
Although male sex is associated with poor prognosis in systemic sclerosis (SSc), it is unclear whether this association is independent of confounding factors such as occupational exposure to toxicants. What is the respective impact of sex and occupational exposure on characteristics of patients with SSc with a focus on lung function decline? Patients with SSc (n = 210; 55 men) underwent standardized quantitative assessment of occupational exposure through a cumulative exposure score (CES) in a multicenter recruitment retrospective cohort. Association of the CES with patients' characteristics was assessed. Mixed linear, logistic, and Cox regression models were used to identify predictors of time variation of FVC and the diffusing capacity of the lungs for CO Male sex was associated strongly with occupational exposure (OR, 10.3; P < .0001). The CES was correlated inversely (r = -0.20) and associated independently with decline in FVC over time and with occurrence of FVC decline of ≥ 10% from baseline (P < .05). By contrast, the CES was not associated with decline in Dlcoc or Dlcoc decline of ≥ 15%. No independent association was found between sex and decline in FVC or Dlcoc. The prevalence of interstitial lung disease was similar across sex or occupational exposure. Occupational exposure to toxicants seems to predict decline of FVC in patients with SSc independently, regardless of sex. Assessment of occupational exposure may be useful for SSc prognostication.
Sections du résumé
BACKGROUND
Although male sex is associated with poor prognosis in systemic sclerosis (SSc), it is unclear whether this association is independent of confounding factors such as occupational exposure to toxicants.
RESEARCH QUESTION
What is the respective impact of sex and occupational exposure on characteristics of patients with SSc with a focus on lung function decline?
STUDY DESIGN AND METHODS
Patients with SSc (n = 210; 55 men) underwent standardized quantitative assessment of occupational exposure through a cumulative exposure score (CES) in a multicenter recruitment retrospective cohort. Association of the CES with patients' characteristics was assessed. Mixed linear, logistic, and Cox regression models were used to identify predictors of time variation of FVC and the diffusing capacity of the lungs for CO
RESULTS
Male sex was associated strongly with occupational exposure (OR, 10.3; P < .0001). The CES was correlated inversely (r = -0.20) and associated independently with decline in FVC over time and with occurrence of FVC decline of ≥ 10% from baseline (P < .05). By contrast, the CES was not associated with decline in Dlcoc or Dlcoc decline of ≥ 15%. No independent association was found between sex and decline in FVC or Dlcoc. The prevalence of interstitial lung disease was similar across sex or occupational exposure.
INTERPRETATION
Occupational exposure to toxicants seems to predict decline of FVC in patients with SSc independently, regardless of sex. Assessment of occupational exposure may be useful for SSc prognostication.
Identifiants
pubmed: 34793760
pii: S0012-3692(21)04294-X
doi: 10.1016/j.chest.2021.11.009
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1011-1021Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.