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Risk factors for the development of idiopathic pulmonary fibrosis: A review.

ABSTRACT: Purpose of Review:Idiopathic pulmonary fibrosis (IPF) is an invariably progressive disease. Current treatment options simply slow disease progression and better therapeutic options are needed. We aimed to review emerging literature on risk factors associated with the development of IPF. Recent findings:There is increasing data to support the role of intrinsic risk factors (e.g. genetics, aging, sex, lung microbiome), co-morbidities (e.g. gastroesophageal reflux, obstructive sleep apnea, diabetes mellitus, herpes virus infection), and extrinsic risk factors (e.g. cigarette smoking, environmental exposures, air pollution) in IPF development. These risk factors may independently increase susceptibility for IPF or act in a synergistic fashion to contribute to increased risk for disease development. Summary:Various risk factors have been identified in IPF development that fit within the current paradigm of disease pathogenesis. Further investigation in to these risk factors may help us better understand the pathophysiology of IPF and may guide future therapeutic interventions.

SUBMITTER: Zaman T

PROVIDER: S-EPMC6777743 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Risk factors for the development of idiopathic pulmonary fibrosis: A review.

Zaman Tanzira T Lee Joyce S JS

Current pulmonology reports 20181016 4

<h4>Purpose of review</h4>Idiopathic pulmonary fibrosis (IPF) is an invariably progressive disease. Current treatment options simply slow disease progression and better therapeutic options are needed. We aimed to review emerging literature on risk factors associated with the development of IPF.<h4>Recent findings</h4>There is increasing data to support the role of intrinsic risk factors (e.g. genetics, aging, sex, lung microbiome), co-morbidities (e.g. gastroesophageal reflux, obstructive sleep ...[more]

PMID: 31588408

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Project description:Background Sarcopenia often occurs as a comorbidity in many diseases which ultimately affects patient prognosis. However, it has received little attention in patients with idiopathic pulmonary fibrosis (IPF). This systematic review and meta-analysis aimed at determining the prevalence and risk factors of sarcopenia in patients with IPF. Methods Embase, MEDLINE, Web of Science, and Cochrane databases were searched using relevant MeSH terms until December 31, 2022. The Newcastle-Ottawa Scale (NOS) was used for quality assessment and data analysis were performed using Stata MP 17.0 (Texas, USA). A random effects model was adopted to account for differences between articles, and the I2 statistic was used to describe statistical heterogeneities. Overall pooled estimates obtained from a random effects model were estimated using the metan command. Forest plots were generated to graphically represent the data of the meta-analysis. Meta-regression analysis was used for count or continuous variables. Egger test was used to evaluate publication bias and, if publication bias was observed, the trim and fill method was used. Main results The search results showed 154 studies, and five studies (three cross-section and two cohort studies) with 477 participants were finally included. No significant heterogeneity was observed among studies included in the meta-analysis (I2 = 16.00%) and our study's publication bias is low (Egger test, p = 0.266). The prevalence of sarcopenia in patients with IPF was 26% (95% CI, 0.22–0.31). The risk factors for sarcopenia in patients with IPF were age (p = 0.0131), BMI (p = 0.001), FVC% (p < 0.001), FEV1% (p = 0.006), DLco% (p ≤ 0.001), and GAP score (p = 0.003). Conclusions The pooled prevalence of sarcopenia in patients with IPF was 26%. The risk factors for sarcopenia in IPF patients were age, BMI, FVC%, FEV1%, DLco%, and GAP score. It is important to identify these risk factors as early as possible to improve the life quality of patients with IPF.

Project description:OBJECTIVE:To clarify prognostic factors of acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF). DESIGN:A systematic review and meta-analysis. DATA SOURCES:Medline, Embase and Science Citation Index Expanded were searched from 2002 through 1 March 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES:The review included primary studies addressing the association between the outcomes such as all-cause mortality of AE of IPF and its potential prognostic factors, which were designated as any clinical information related to the outcomes. DATA EXTRACTION AND SYNTHESIS:Two reviewers extracted relevant data independently and assessed risk of bias. Univariate results were pooled using a random-effect model if at least three studies were available. Prognostic factors were determined based on significant and consistent results on both univariate and multivariate analyses in the majority of studies. RESULTS:Out of a total of 6763 articles retrieved, 37 were eligible and 31 potential prognostic factors for all-cause mortality were selected. Each study was subject to certain methodological shortcomings. The following five factors were statistically significant by a meta-analysis of univariate results, which was confirmed by multivariate analysis, that is, Acute Physiology and Chronic Health Evaluation (APACHE) II score (HR 1.10, 1.01 to 1.19), partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio (ORs 0.99 in two studies and HRs 0.31 and 0.99 in two studies, respectively), lactate dehydrogenase (LDH) (HRs 1.002, 1.003, 1.01 and 1.02), white blood cell (WBC) count (OR 1.38, 1.04 to 1.83) and oxygen therapy before AE (HRs 3.68, 1.05 to 12.9 and 2.34, 1.04 to 5.28) (multivariate analysis, 95% CI). CONCLUSIONS:APACHE II score, PaO2/FiO2 ratio, LDH, WBC count and oxygen therapy before AE were deemed as prognostic factors of AE of IPF. Although there are some methodological limitations in this study, these findings are reliable due to consistent results by both univariate and multivariate analyses. PROSPERO REGISTRATION NUMBER:CRD42018106172.

Project description:BackgroundPrevious observational studies have investigated the association between endocrine and metabolic factors and idiopathic pulmonary fibrosis (IPF), yet have produced inconsistent results. Therefore, it is imperative to employ the Mendelian randomization (MR) analysis method to conduct a more comprehensive investigation into the impact of endocrine and metabolic factors on IPF.MethodsThe instrumental variables (IVs) for 53 endocrine and metabolic factors were sourced from publicly accessible genome-wide association study (GWAS) databases, with GWAS summary statistics pertaining to IPF employed as the dependent variables. Causal inference analysis encompassed the utilization of three methods: inverse-variance weighted (IVW), weighted median (WM), and MR-Egger. Sensitivity analysis incorporated the implementation of MR-PRESSO and leave-one-out techniques to identify potential pleiotropy and outliers. The presence of horizontal pleiotropy and heterogeneity was evaluated through the MR-Egger intercept and Cochran's Q statistic, respectively.ResultsThe IVW method results reveal correlations between 11 traits and IPF. After correcting for multiple comparisons, seven traits remain statistically significant. These factors include: "Weight" (OR= 1.44; 95% CI: 1.16, 1.78; P=8.71×10-4), "Body mass index (BMI)" (OR= 1.35; 95% CI: 1.13, 1.62; P=1×10-3), "Whole body fat mass" (OR= 1.40; 95% CI: 1.14, 1.74; P=1.72×10-3), "Waist circumference (WC)" (OR= 1.54; 95% CI: 1.16, 2.05; P=3.08×10-3), "Trunk fat mass (TFM)" (OR=1.35; 95% CI: 1.10,1.65; P=3.45×10-3), "Body fat percentage (BFP)" (OR= 1.55; 95% CI: 1.15,2.08; P=3.86×10-3), "Apoliprotein B (ApoB)" (OR= 0.78; 95% CI: 0.65,0.93; P=5.47×10-3). Additionally, the sensitivity analysis results confirmed the reliability of the MR results.ConclusionThe present study identified causal relationships between seven traits and IPF. Specifically, ApoB exhibited a negative impact on IPF, while the remaining six factors demonstrated a positive impact. These findings offer novel insights into the underlying etiopathological mechanisms associated with IPF.

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Risk factors for the development of idiopathic pulmonary fibrosis: A review.

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Risk factors for the development of idiopathic pulmonary fibrosis: A review.

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