Annals of the American Thoracic Society最新文献

{"title":"Prevalence of Interstitial Lung Abnormalities in Adult Smokers.","authors":"Fayez Kheir, Gary M Hunninghake, Yet H Khor, Brandon Pang, Anna Podolanczuk, Christopher J Ryerson, David A Schwartz, Kevin C Wilson","doi":"10.1513/AnnalsATS.202412-1256RL","DOIUrl":"10.1513/AnnalsATS.202412-1256RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1097-1100"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy of Tirzepatide, Liraglutide, and Semaglutide in Reduction of Risk of Major Adverse Cardiovascular Events in Patients with Obstructive Sleep Apnea and Type 2 Diabetes: Real-World Evidence.","authors":"Alex E Henney, David R Riley, Matthew Anson, Megan Heague, Gema Hernadez, Uazman Alam, Sonya Craig, Daniel J Cuthbertson","doi":"10.1513/AnnalsATS.202409-923OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202409-923OC","url":null,"abstract":"<p><p><b>Rationale:</b> Glucagon-like peptide-1 (GLP-1) receptor agonists (liraglutide, semaglutide) and dual glucose-dependent insulinotropic polypeptide (GLP-1/GIP) receptor agonists (tirzepatide) are approved for treatment of type 2 diabetes (T2D) and obesity. <b>Objective:</b> To compare the relative efficacy of tirzepatide, liraglutide, and semaglutide in reducing major adverse cardiovascular events (MACEs) in patients with obstructive sleep apnea (OSA) and T2D. <b>Methods:</b> We performed a retrospective cohort analysis in a large global federated database of patients with OSA and T2D. Two cohorts were generated, both with a treatment arm of patients prescribed tirzepatide. Liraglutide and semaglutide-treated patients provided the reference arms in cohort 1 and cohort 2, respectively. Cohorts underwent propensity-score matching at a 1:1 ratio for confounders. We examined rates of incident MACEs (composite outcome and individual components) over an 18-month follow up, and performed stratified analyses by body mass index, age, sex, and ethnicity. Finally, we assessed incident OSA in a secondary analysis of patients with T2D treated with tirzepatide compared with liraglutide and semaglutide. <b>Results:</b> After matching, each treatment arm included 7,836 patients in cohort 1 and 7,394 patients in cohort 2. Tirzepatide reduced the risk of incident MACEs compared with liraglutide (hazard ratio, 0.58; 95% confidence interval, 0.51-0.66) and semaglutide (0.86; 0.74-0.99). Tirzepatide was more efficacious in younger, male patients of White ethnicity. Moreover, tirzepatide reduced incident OSA compared with liraglutide (0.89; 0.82-0.97) but not semaglutide (0.94; 0.86-1.02). <b>Conclusions:</b> In patients with OSA and T2D, tirzepatide is associated with a lower incidence of MACEs compared with liraglutide and semaglutide. More robust randomized, controlled evidence is needed for these drugs in patients who are at such high risk.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":"22 7","pages":"1042-1052"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Prevalence, and Mortality of Interstitial Lung Diseases in Alberta, Canada: A Population-based Study.","authors":"Kerri A Johannson, Zhaoyu Liu, Danielle A Southern, Meena Kalluri, Andrea S Gershon, Erica Farrand, Amanda Grant-Orser, Jolene H Fisher","doi":"10.1513/AnnalsATS.202406-625OC","DOIUrl":"10.1513/AnnalsATS.202406-625OC","url":null,"abstract":"<p><p><b>Rationale:</b> The epidemiology of adult interstitial lung disease (ILD) is uncertain, given heterogeneous estimates from prior studies. <b>Objective:</b> We sought to define the incidence, prevalence, and mortality of ILD over a 10-year period using population-based data. <b>Methods:</b> We created an administrative ILD cohort in Alberta, Canada between 2010 and 2019 using population-based administrative data (inpatient, ambulatory, and outpatient physician billing databases) for a repeat cross-sectional study. Case definitions were developed from an established ILD cohort and applied to the general population, with performance characteristics tested using a nested case-control design. Age- and sex-standardized annual incidence and point prevalence rates were estimated for ILD overall and within diagnostic subgroups, with trends over time, per 100,000 at-risk adults and to permit comparisons with other studies, per 100,000 total population. Cox models estimated risk of death or lung transplantation. <b>Results:</b> Between 2010 and 2019, 31,492 incident and 42,549 prevalent adult ILD cases were identified. The case definition for ILD performed well with 96.8% sensitivity, 98.5% specificity, and a positive predictive value of 94.3% in the population cohort. Mean age-standardized ILD incidence was 107.9/100,000 at-risk adults, 90.9/100,000 for females and 129.1/100,000 for males. Age-standardized ILD point prevalence increased from 416.5/100,000 at-risk adults in 2010 to 789.7/100,000 in 2019, higher in males versus females, and in rural versus urban areas. Age-standardized mean idiopathic pulmonary fibrosis (IPF) incidence was 36.9/100,000 at-risk adults, and point prevalence was 205.3/100,000 at-risk adults in 2019. Mean age-standardized ILD incidence and prevalence was 84 and 516.9/100,000 total population, respectively. One-year all-cause mortality for ILD patients decreased from 14.5% in 2011 to 11.7% in 2018 (for 2018 vs. 2011, adjusted rate ratio = 0.76; 95% confidence interval = 0.67-0.86). One-year all-cause mortality for IPF similarly decreased from 20.9% in 2011 to 14.7% in 2018 (for 2018 vs. 2011, adjusted rate ratio = 0.71; 95% confidence interval = 0.59-0.85), representing improved survival. <b>Conclusions:</b> In this population-based cohort, claims-based case definitions derived from an established ILD cohort performed well to develop an administrative cohort. Incidence remained stable over time, whereas prevalence increased and mortality decreased, for ILD overall and within the IPF subgroup. These estimates are higher than most prior reports, suggesting an overall underestimate of ILD burden.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1009-1017"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider Practices in Pulmonary Exacerbations of Cystic Fibrosis in the Era of Highly Effective Modulator Therapy.","authors":"Alexandra Toporek, Shivani Patel, Kevin J Psoter, Noah Lechtzin, Kristin A Riekert, Natalie E West","doi":"10.1513/AnnalsATS.202408-831OC","DOIUrl":"10.1513/AnnalsATS.202408-831OC","url":null,"abstract":"<p><p><b>Rationale:</b> Since the approval of elexacaftor/tezacaftor/ivacaftor (ETI), data suggest that there have been changes in the management of pulmonary exacerbations (PEx) of cystic fibrosis. <b>Objectives:</b> Given the subjective nature of PEx diagnosis and management, we sought to characterize provider PEx management practices in people with cystic fibrosis (pwCF) prescribed highly effective modulator therapy (HEMT) and to identify practice changes that may impact clinical outcomes. <b>Methods:</b> We conducted semistructured qualitative interviews among clinicians in the United States from late 2021 to 2022 to investigate changes in the management of PEx in pwCF prescribed ETI. Inductive coding of transcripts was used in a thematic analysis. <b>Results:</b> We conducted 19 qualitative interviews with providers at 15 cystic fibrosis centers. Thematic analysis identified five themes regarding the presentation, diagnosis, and management of PEx in pwCF prescribed ETI. <i>1</i>) PEx have changed in the era of HEMT to become a more subtle pathology that may result in providers questioning PEx diagnosis. <i>2</i>) Providers feel less anxious about clinical outcomes after PEx. <i>3</i>) Providers are expanding their assessment of PEx in the era of HEMT to identify more subtle PEx phenotypes. <i>4</i>) pwCF are driving their care during PEx more than in the pre-HEMT era, with interviewees reporting that some <i>\"patients don't really contact us</i> [with mild PEx symptoms].<i>… We hear about it in retrospect.\"</i> Interviewees expressed concern that this may result in more severe PEx. 5) Provider management is less aggressive in the post-HEMT era, reflecting reduced PEx severity. Participants emphasized that their approach to PEx in general is unchanged and that <i>\"</i>[providers] <i>treat depending on severity … and the background of the patient</i>.\" Interviewees reported they increasingly recommend maintenance therapies for PEx treatment before prescribing antibiotics. <b>Conclusions:</b> Participants report that PEx in pwCF prescribed ETI appear milder, resulting in less anxiety about outcomes and a more conservative approach to management. Providers express uncertainty regarding the diagnosis of PEx, given its evolving presentation and reduced in-person evaluation. Further research is necessary to identify sensitive markers of PEx and to assess the impact of conservative management on clinical outcomes.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"992-997"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-Urban Patterns in Household Rules Limiting Combustible Tobacco, Noncombustible Tobacco, and E-Cigarette Use.","authors":"Alexander W Steinberg, Jenny E Ozga, Zhiqun Tang, Cassandra A Stanton, James D Sargent, Laura M Paulin","doi":"10.1513/AnnalsATS.202504-419OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202504-419OC","url":null,"abstract":"<p><strong>Rationale: </strong>Rural Americans experience higher rates of smoking and smoking-associated disease compared to urban Americans. Household rules limiting smoking inside the home decrease secondhand smoke exposure and may facilitate quitting among those who smoke. Limited research suggests that rural Americans are less likely to report household smoking restrictions. We studied the relationship between rurality and household rules limiting combustible tobacco, non-combustible tobacco, and electronic cigarette (e-cigarette) use.</p><p><strong>Methods: </strong>Cross-sectional data for 10,126 United States respondents aged ≥ 40 years from the Population Assessment of Tobacco and Health Study Wave 5 (2018-2019) was used to assess the relationship between residence rurality (rural, small-town, suburban, urban) and household rules limiting combustible tobacco, non-combustible tobacco, or e-cigarette use. Multivariable Poisson regression analyses were adjusted for respondent age, sex, race, education, family income, and product use.</p><p><strong>Results: </strong>Rural (vs urban) respondents more commonly allowed combustible tobacco (17.6% vs 13.6%), non-combustible tobacco (26.4% vs 16.4%), and e-cigarette use (20.8% vs 15.1%) in the home. The fully adjusted risk ratio (ARR) for rural (vs urban) homes was 1.27; 95% CI [1.12, 1.44] for combustible tobacco, 1.36; 95% CI [1.20, 1.54] for noncombustible tobacco, and 1.34; 95% CI [1.17, 1.55] for e-cigarettes. Small-town respondents had similarly increased ARRs, while suburban respondents' ARRs were not different compared to the urban reference group.</p><p><strong>Conclusions: </strong>Rural and small-town Americans were more likely to allow household use of all tobacco product types compared to urban respondents. This pattern persisted when adjusted for socioeconomic factors and respondent product use. These findings may help address tobacco-related diseases that disproportionately affect rural Americans.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 Pandemic on Interstitial Lung Disease Healthcare Utilization & Outcomes: A Population Study in Alberta, Canada.","authors":"Jason Weatherald, Chuan Wen, Kerri Johannson, Paul E Ronksley, Jeffrey A Bakal, Michael K Stickland, Douglas P Gross, Grace Y Lam","doi":"10.1513/AnnalsATS.202412-1311RL","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202412-1311RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Cancer Mortality by County, Race and/or Ethnicity, and Sex in the USA, 2000-2019.","authors":"Somy Hooshmand, Erik J Rodriquez, Paula D Strassle, George A Mensah, Kelvin Choi, Kristen R Hamilton-Mosely, Stephanie M George, Laura Dwyer-Lindgren, Ali Mokdad, Ethan Kahn, Yekaterina O Kelly, Zhuochen Li, Dillon O Sylte, Mathew M Baumann, Wichada La Motte-Kerr, Amanda Hinerman, Sherine El-Toukhy, Eliseo J Pérez-Stable","doi":"10.1513/AnnalsATS.202504-398OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202504-398OC","url":null,"abstract":"<p><strong>Rationale: </strong>Examining lung cancer mortality trends at the county level would better inform our understanding of racial, ethnic, and geographic differences in the U.S.</p><p><strong>Objective: </strong>To analyze lung cancer mortality trends by race and/or ethnicity (American Indian or Alaska Native [AIAN], Asian, Black, Latino, and White), sex, and county.</p><p><strong>Methods: </strong>Data from the National Vital Statistics System and National Center for Health Statistics (2000-2019) were used to estimate age-standardized lung cancer mortality in 3,110 counties, adjusted for misclassification.</p><p><strong>Measurements and main results: </strong>From 2000 to 2019, lung cancer mortality decreased from 68.3 (95% uncertainty interval [UI]: 67.9-68.7) to 42.5 (42.3-42.8) deaths per 100,000. Males experienced a larger decrease (44.8%) than females (29.4%). Similar patterns were observed at the county level, with considerable geographic variation within and across racial and/or ethnic populations. In 2019, higher rates among Black and White populations were observed in the Mississippi River watershed and Appalachia; and AIAN populations in the upper Midwest, Northeast, North Carolina, Oklahoma, and Kansas. From 2000 to 2019, for males and females combined, lung cancer mortality rates increased in 57 counties (12.0%) for the AIAN population, with a median increase of 7.5 deaths per 100,000. Increases in counties were less common among Asian (n=36, 5.4%), Latino (n=36, 2.4%), and White (n=1) populations, while no county showed an increase for Black individuals.</p><p><strong>Conclusions: </strong>Despite marked reductions in lung cancer mortality, geographic and racial and/or ethnic differences persist, which emphasizes the need for targeted interventions to further improve lung cancer outcomes for all populations.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sirolimus Use During Pregnancy in Women with Lymphangioleiomyomatosis.","authors":"Rachana Krishna, Simon R Johnson, Ali Ataya, Misbah Baqir, Bruno Guedes Baldi, Carlos E Girod, Remi Diesler, Elizabeth P Henske, Kai-Feng Xu, Nishant Gupta","doi":"10.1513/AnnalsATS.202504-433RL","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202504-433RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Trajectories Around Non-Invasive Ventilation Initiation For Obesity Hypoventilation Syndrome.","authors":"Jean-Louis Pépin, Eleonore Herquelot, Hélène Denis, Anne Josseran, Florent Lavergne, Adam V Benjafield, Atul Malhotra, Peter A Cistulli, Aurélie Schmidt, Sébastien Bailly, Alain Palot, Arnaud Prigent","doi":"10.1513/AnnalsATS.202411-1160OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202411-1160OC","url":null,"abstract":"<p><strong>Rationale: </strong>Positive airway pressure therapy modalities in obesity hypoventilation syndrome (OHS) are still debated.</p><p><strong>Objective(s): </strong>To describe health trajectories before and after starting non-invasive ventilation (NIV) and compare post-NIV outcomes between groups with different pre-NIV trajectories.</p><p><strong>Methods: </strong>Data came from the French national health insurance reimbursement database for individuals with OHS and ≥1 NIV prescription between 1 January 2015 and 31 December 2019. Health trajectory clusters were determined using mixture models being graphically represented by time sequence analysis.</p><p><strong>Results: </strong>Data from 8,842 individuals were analyzed (59.7% had coexisting obstructive sleep apnea, 64% had ≥1 comorbidity). Median follow-up was 3.1 years. Cluster 1 (n=5,853; 66.2%) started NIV while stable after pulmonary function testing (PFT), arterial blood gases (ABG) and sleep studies; 23.7% underwent bariatric surgery around NIV initiation. One-year therapy termination and mortality rates were 51.8% and 5.5%, respectively. Cluster 2 (n=757; 8.6%) started NIV during or immediately after ≥1 acute intensive care unit hospitalization in the previous year; one-year NIV termination and mortality rates were 34.3% and 9.1%, respectively. Cluster 3 (n=526; 5.9%) had NIV initiation after a sleep study, PFTs/ABG and 3 months of continuous positive airway pressure (CPAP); one-year therapy termination and mortality rates were 23.0% and 2.1%, respectively. In Cluster 4 (n=1,706; 19.3%), long-term CPAP preceded the switch to NIV after reassessment in ambulatory care; one-year therapy termination and mortality rates were 18.4% and 4.5%, respectively.</p><p><strong>Conclusions: </strong>These novel data highlight marked heterogeneity in OHS and use of PAP therapies, which significantly impacts outcomes. Primary source of funding: ResMed.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-Low Dose Thoracic CT Derived Morphomics in Cystic Fibrosis Patients on Elexacaftor/Tezacaftor/Ivacaftor.","authors":"Patrick W O' Regan, Hisham I S Ibrahim, Sean Blackburn, Alexander T O' Mahony, Michael G Waldron, Sahil S Shet, Kevin F Deasy, Barry J Plant, David J Ryan, Michael M Maher","doi":"10.1513/AnnalsATS.202411-1151OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202411-1151OC","url":null,"abstract":"<p><strong>Rationale: </strong>In cystic fibrosis (CF), body composition alterations are observed. Prevalence of obesity in CF is increasing with evidence suggesting a subsequent increase in cardiometabolic risk. We sought to assess body composition using analytic morphomics (AM) from ultra-low dose thoracic CT scans in CF patients on the triple CFTR modulator therapy, Elexacaftor/Tezacaftor/Ivacaftor (ETI). Objective Our objective was to use analytical morphomics on routine ultra-low dose CTs to assess patterns of change in body composition in CF patients on ETI therapy. Methods Forty-two CF patients on ETI who had baseline and follow up ultra-low dose thoracic CT imaging were retrospectively analysed. The CTs were acquired at a radiation dose equivalent to 2 frontal chest x-rays using our previously published acquisition parameters. The Bhalla score was used as a marker of structural lung disease severity. AM variables including: cross sectional area (CSA) and attenuation of pectoralis muscle, visceral fat (epicardial and upper abdominal) and subcutaneous fat were extracted using the validated image segmentation software, CoreSlicer. Paired samples mean testing (Wilcoxon matched pairs signed rank test) and Spearman rank correlation analyses were performed. Results Total Bhalla scores significantly improved over time in patients on ETI (p < 0.0001). In addition, body composition also changed with an increase in the CSA of subcutaneous, and epicardial visceral fat (p values < 0.0001, and 0.0062, respectively). In those with a normal BMI at follow up, epicardial, and subcutaneous fat had also increased significantly in the interval (p = 0.0066, and 0.0002, respectively). Conclusion In CF, ETI produced a significant improvement in structural lung disease over time, however also resulted in an increase in visceral and subcutaneous fat. The AM methodology presented herein, may help identify those patients for aggressive primary prevention strategies and permit the creation of more personalised nutritional plans.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}