Abstract
BackgroundFactors determining the shape of the human rib cage are not completely understood. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers.MethodsRib cage diameters and areas (calculated from the inner surface of the rib cage) in 816 smokers with or without COPD, were evaluated at three anatomical levels using computed tomography (CT). CTs were analyzed with software, which allows quantification of total emphysema (emphysema%). The relationship between rib cage measurements and anthropometric factors, lung function indices, and %emphysema were tested using linear regression models.ResultsA model that included gender, age, BMI, emphysema%, forced expiratory volume in one second (FEV1)%, and forced vital capacity (FVC)% fit best with the rib cage measurements (R2 = 64% for the rib cage area variation at the lower anatomical level). Gender had the biggest impact on rib cage diameter and area (105.3 cm2; 95% CI: 111.7 to 98.8 for male lower area). Emphysema% was responsible for an increase in size of upper and middle CT areas (up to 5.4 cm2; 95% CI: 3.0 to 7.8 for an emphysema increase of 5%). Lower rib cage areas decreased as FVC% decreased (5.1 cm2; 95% CI: 2.5 to 7.6 for 10 percentage points of FVC variation).ConclusionsThis study demonstrates that simple CT measurements can predict rib cage morphometric variability and also highlight relationships between rib cage morphometry and emphysema.
Highlights
Anthropometric variables such as height, weight, sex, and age affect rib cage dimensions and morphology [1,2,3,4]
The inter-operator mean differences ranged from 0.03 mm to 24.9 mm and from 20.7 cm2 to 21.1 cm2 for the diameters and the areas respectively over the first 100 consecutive MILD computed tomography (CT)
There were three cases (0.4%) with interstitial lung disease consistent with usual interstitial pneumonia (UIP), this was limited in extent
Summary
Anthropometric variables such as height, weight, sex, and age affect rib cage dimensions and morphology [1,2,3,4]. Several lung diseases are independent determinants of the rib cage variability [5,10,11,12,13,14]. COPD is likely to produce complex changes in the rib cage dimensions and shape [5,15,18,19]. This has been suggested by previous investigations based on clinical assessment and chest radiographic techniques [20,21]. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers
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