The significance of smoking as a risk factor for the disorder of the obstructive pulmonary pattern in the patients with systemic sclerosis

Jelena Stefanović Nešković; Milan Petronijević; Andjelka Ristić; Branka Djurović; Silvija Stević-Carević; Branimir Nešković

doi:10.2298/VSP170205111S

Jelena Stefanović Nešković Military Medical Academy, Clinic for Rheumatology and Immunology, Belgrade, Serbia
Milan Petronijević Military Medical Academy, Clinic for Rheumatology and Immunology, Belgrade, Serbia
Andjelka Ristić Military Medical Academy, Clinic for Emergency and Internal Medicine, Belgrade, Serbia
Branka Djurović University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Silvija Stević-Carević Military Medical Academy, Clinic for Rheumatology and Immunology, , Belgrade, Serbia
Branimir Nešković Military Medical Academy, Clinic for General Surgery, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170205111S

Keywords: scleroderma, systemic;, lung diseases, obstructive;, risk factors;, smoking.

Abstract

Background/Aim. Systemic sclerosis (SSc) is a chronic systemic disease of the connective tissue. It is characterized by diffuse microangiopathy, increased activity and creating deposits of collagen in the skin and internal organs. Involvement of the lung function disturbances in SSc is a bad prognostic sign. The aim of our study was to investigate the association between smoking habits and lung function disorder in the SSc patients. Methods. The testing was conducted at the Clinic for Rheumatology and Immunology of the Military Medical Academy in 2016. In this study, we included 42 patients with the newly diagnosed SSc and the patients whose disease had been diagnosed earlier. Results. The patients were classified according to the smoking habits, 14 (33.3%) patients were nonsmokers, while 28 (66.7%) patients were current (23 patients) or ex-smokers (5 patients). We found no significant differences in examined parameters among smokers and nonsmokers. In addition, distribution of the patients with the obstructive pulmonary pattern revealed by spirometry was uniform between smokers and nonsmokers. The concentrations of C reactive protein (CRP) were significantly higher in the SSc patients with the obstructive pulmonary pattern. The patients with the obstructive pattern on spirometry had significantly lower values of forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, diffusing lung capacity for carbon monoxide (DLCO) and FVC/DLCO ratio. Conclusion. In our study, we concluded that in the SSc patients with the obstructive pulmonary pattern revealed by spirometry, there were no significant differences between smokers and non-smokers. CRP is a significant predictor of the lung involvement existence in the SSc patients.

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