Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk.
<h4>Background</h4>Chronic inflammation may increase susceptibility to pneumonia.<h4>Research question</h4>To explore associations between clinical comorbidities, serum protein immunoassays, and long-term pneumonia risk.<h4>Methods</h4>Framingham Heart Study Offsp...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2024-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0296139 |
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| author | Ming-Ming Lee Yi Zuo Katrina Steiling Joseph P Mizgerd Bindu Kalesan Allan J Walkey |
| author_facet | Ming-Ming Lee Yi Zuo Katrina Steiling Joseph P Mizgerd Bindu Kalesan Allan J Walkey |
| author_sort | Ming-Ming Lee |
| collection | DOAJ |
| description | <h4>Background</h4>Chronic inflammation may increase susceptibility to pneumonia.<h4>Research question</h4>To explore associations between clinical comorbidities, serum protein immunoassays, and long-term pneumonia risk.<h4>Methods</h4>Framingham Heart Study Offspring Cohort participants ≥65 years were linked to their Centers for Medicare Services claims data. Clinical data and 88 serum protein immunoassays were evaluated for associations with 10-year incident pneumonia risk using Fine-Gray models for competing risks of death and least absolute shrinkage and selection operators for covariate selection.<h4>Results</h4>We identified 1,370 participants with immunoassays and linkage to Medicare data. During 10 years of follow up, 428 (31%) participants had a pneumonia diagnosis. Chronic pulmonary disease [subdistribution hazard ratio (SHR) 1.87; 95% confidence interval (CI), 1.33-2.61], current smoking (SHR 1.79, CI 1.31-2.45), heart failure (SHR 1.74, CI 1.10-2.74), atrial fibrillation/flutter (SHR 1.43, CI 1.06-1.93), diabetes (SHR 1.36, CI 1.05-1.75), hospitalization within one year (SHR 1.34, CI 1.09-1.65), and age (SHR 1.06 per year, CI 1.04-1.08) were associated with pneumonia. Three baseline serum protein measurements were associated with pneumonia risk independent of measured clinical factors: growth differentiation factor 15 (SHR 1.32; CI 1.02-1.69), C-reactive protein (SHR 1.16, CI 1.06-1.27) and matrix metallopeptidase 8 (SHR 1.14, CI 1.01-1.30). Addition of C-reactive protein to the clinical model improved prediction (Akaike information criterion 4950 from 4960; C-statistic of 0.64 from 0.62).<h4>Conclusions</h4>Clinical comorbidities and serum immunoassays were predictive of pneumonia risk. C-reactive protein, a routinely-available measure of inflammation, modestly improved pneumonia risk prediction over clinical factors. Our findings support the hypothesis that prior inflammation may increase the risk of pneumonia. |
| format | Article |
| id | doaj-art-d041425d74bb48a19c44f823cc0643ca |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-d041425d74bb48a19c44f823cc0643ca2025-08-20T03:28:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01197e029613910.1371/journal.pone.0296139Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk.Ming-Ming LeeYi ZuoKatrina SteilingJoseph P MizgerdBindu KalesanAllan J Walkey<h4>Background</h4>Chronic inflammation may increase susceptibility to pneumonia.<h4>Research question</h4>To explore associations between clinical comorbidities, serum protein immunoassays, and long-term pneumonia risk.<h4>Methods</h4>Framingham Heart Study Offspring Cohort participants ≥65 years were linked to their Centers for Medicare Services claims data. Clinical data and 88 serum protein immunoassays were evaluated for associations with 10-year incident pneumonia risk using Fine-Gray models for competing risks of death and least absolute shrinkage and selection operators for covariate selection.<h4>Results</h4>We identified 1,370 participants with immunoassays and linkage to Medicare data. During 10 years of follow up, 428 (31%) participants had a pneumonia diagnosis. Chronic pulmonary disease [subdistribution hazard ratio (SHR) 1.87; 95% confidence interval (CI), 1.33-2.61], current smoking (SHR 1.79, CI 1.31-2.45), heart failure (SHR 1.74, CI 1.10-2.74), atrial fibrillation/flutter (SHR 1.43, CI 1.06-1.93), diabetes (SHR 1.36, CI 1.05-1.75), hospitalization within one year (SHR 1.34, CI 1.09-1.65), and age (SHR 1.06 per year, CI 1.04-1.08) were associated with pneumonia. Three baseline serum protein measurements were associated with pneumonia risk independent of measured clinical factors: growth differentiation factor 15 (SHR 1.32; CI 1.02-1.69), C-reactive protein (SHR 1.16, CI 1.06-1.27) and matrix metallopeptidase 8 (SHR 1.14, CI 1.01-1.30). Addition of C-reactive protein to the clinical model improved prediction (Akaike information criterion 4950 from 4960; C-statistic of 0.64 from 0.62).<h4>Conclusions</h4>Clinical comorbidities and serum immunoassays were predictive of pneumonia risk. C-reactive protein, a routinely-available measure of inflammation, modestly improved pneumonia risk prediction over clinical factors. Our findings support the hypothesis that prior inflammation may increase the risk of pneumonia.https://doi.org/10.1371/journal.pone.0296139 |
| spellingShingle | Ming-Ming Lee Yi Zuo Katrina Steiling Joseph P Mizgerd Bindu Kalesan Allan J Walkey Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk. PLoS ONE |
| title | Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk. |
| title_full | Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk. |
| title_fullStr | Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk. |
| title_full_unstemmed | Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk. |
| title_short | Clinical risk factors and blood protein biomarkers of 10-year pneumonia risk. |
| title_sort | clinical risk factors and blood protein biomarkers of 10 year pneumonia risk |
| url | https://doi.org/10.1371/journal.pone.0296139 |
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