Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 16

Association Between Airflow Limitation and Carotid Intima-Media Thickness in the Japanese Population

Authors Watanabe K, Onoue A, Omori H, Kubota K, Yoshida M, Katoh T

Received 20 November 2020

Accepted for publication 22 February 2021

Published 19 March 2021 Volume 2021:16 Pages 715—726


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Kazuhiko Watanabe,1 Ayumi Onoue,2 Hisamitsu Omori,2 Kenichi Kubota,3 Minoru Yoshida,3 Takahiko Katoh1

1Department of Public Health, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan; 2Department of Biomedical Laboratory Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan; 3Japanese Red Cross Kumamoto Health Care Center, Kumamoto, Japan

Correspondence: Hisamitsu Omori
Department of Biomedical Laboratory Sciences, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku Kumamoto, 862-0976, Japan
Tel/Fax +81-96-373-5462
Email [email protected]

Purpose: This study aimed to reveal the association between airflow limitation (AL) and carotid intima-media thickness (IMT) according to smoking status in Japan.
Subjects and Methods: This cross-sectional study was performed in 2809 subjects, who underwent a comprehensive health examination with pulmonary function tests and carotid ultrasonographic measurement. AL was defined as forced expiratory volume in 1 s/forced vital capacity of < 0.7. The subjects were divided into the following four groups: never smokers without AL, never smokers with AL, former/current smokers without AL, and former/current smokers with AL. Mean IMT, the maximum measurable IMT value in the left and right common carotid arteries (IMT-C max), and mean IMT-C max were measured by carotid ultrasonography. The carotid wall thickness as defined as follows: IMT ≥ 1.1 mm (IMT1.1), IMT-C max ≥ 1.2 mm (IMTc1.2), and IMT-C max > 1.5 mm (IMTc1.5), based on each measured region. The association between AL and the carotid wall thickness according to smoking status was assessed by logistic regression analysis.
Results: The mean carotid IMT and mean IMT-C max were significantly higher in never smokers with AL and former/current smokers with or without AL than in never smokers without AL. In logistic regression models adjusted for sex, age, body mass index, hypertension, dyslipidemia, hyperglycemia, physical activity, and alcohol consumption, the risk of carotid wall thickness (IMT1.1 [odds ratio {OR}: 1.55; 95% confidence interval {CI}: 1.07– 2.24]; IMTc1.2 [OR: 1.52; 95% CI: 1.03– 2.24]; IMTc1.5 [OR: 1.99; 95% CI: 1.15– 3.46]) were significantly higher in former/current smokers with AL than in never smokers without AL.
Conclusion: The present results suggest that greater IMT and risk of carotid wall thickness were associated with AL and smoking experience.

Keywords: chronic obstructive pulmonary disease, cardiovascular disease, comorbidity, atherosclerosis, airflow limitation, carotid intima-media thickness

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]