June 13, 2006 -- Could a glance in the mirror reveal a smoker's risk of emphysemaemphysema and other forms of chronic obstructive pulmonary disease (COPD)chronic obstructive pulmonary disease (COPD)?
A new study links major facial wrinkling to increased risk of COPD in current and former middle-aged smokers.
COPD includes emphysema, chronic bronchitisbronchitis, and several other noncancerous lung problems. Smoking is a leading risk factor for COPD but not all smokers develop the disease.
Smoking is also associated with premature wrinkling, note Bipen Patel and colleagues in a study appearing in the "online first" edition of the journal Thorax.
Patel works in England at Cambridge University's department of public health and primary care.
The study looked at 149 current and former smokers enrolled in an international study on genetics and COPD. Participants were in their mid- to late 50s, on average.
The participants did four things:
- Got high-resolution CT scans of their lungs
- Took a test to see how much air they could forcibly exhale in 1 second
- Had their right and left facial profiles photographed on the same day as the CT scans
- Completed a survey about sun exposure and sunscreen use
The photos weren't exactly glamour shots. Researchers snapped the pictures under normal (not particularly flattering) lighting. They also stuck little markers on the patients' skin to show the scale of their wrinkles.
Who Was Wrinkled?
A pair of dermatologists then reviewed the photos and rated the participants' facial wrinkles. They pored over the photos, gauging crow's feet lines around the eyes, along with wrinkles on the forehead, cheeks, and the rest of the face.
The dermatologists' ratings ranged from grade I ("essentially unwrinkled") to grade VI ("profound wrinkling over most of the face").
Most participants had little or no facial wrinkling, but 25 (nearly 17%) were wrinkled, write Patel and colleagues.
Of the 25 wrinkled participants, 21 had COPD, the researchers found. Overall, 68 of the 149 participants had COPD.
Compared with unwrinkled participants, those with wrinkles were more than eight times as likely to have COPD, the study shows. Wrinkles were also associated with lower scores on the forced exhalation test.
Wrinkled participants were on average slightly older than those with fewer facial lines. But adjusting for that fact -- and for sun exposure and sunscreen use -- didn't affect the results, the researchers say. Wrinkles were also associated with a history of heavier smoking.
A Clue for Patients, Doctors
Why would major facial wrinkles signal COPD?
Wrinkles are normal as people age. The study isn't claiming that routine wrinkles flag extreme lung problems in most people.
However, Patel's team writes that their results suggest that, in the group of current and former smokers they studied, facial wrinkles were "strongly predictive" of airflow obstruction and emphysema.
"Severe facial wrinkling may therefore be a marker of COPD susceptibility" and could signal doctors to screen such people for COPD, the researchers conclude.