Smokers with heavily lined faces run five times the risk of progressive lung disease

Smokers with heavily lined faces run five times the risk of progressive lung disease (COPD)

June 14, 2006

Middle aged smokers, who are heavily lined with wrinkles, are five times as likely to have chronic obstructive pulmonary disease, or COPD for short, suggests research published ahead of print in Thorax.

COPD is an umbrella term for a range of progressive chronic lung diseases, such as emphysema and bronchitis, which block the airways and restrict oxygen flow around the body.

In excess of 1 million people are thought to have COPD in the UK, many of whom have not been diagnosed. And the World Health Organization estimates that it will become the third leading cause of death in the world by 2020.

It is well known that smoking causes premature ageing of the skin, and similarly, most cases of COPD are caused by smoking.

But not all smokers go on to develop COPD, and the researchers wanted to know if the extent of facial wrinkling might provide a clue as to a smoker's likelihood of having the disease.

They studied 149 current and former middle aged smokers from 78 families. In all, 68 people had COPD.

More than 80% (124) of the total sample had no or very few facial lines, and 25 had widespread wrinkles.

Forced expiratory volume in 1 second, which measures lung strength, was significantly lower in those with extensive wrinkling than it was in those whose faces were only minimally lined.

And those with lined faces were five times more likely to have COPD than those without, after taking account of age and the number of years as a smoker. Facial wrinkling was also associate with triple the risk of more severe emphysema.

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Smoking related COPD and facial wrinkling: is there a common susceptibility?: Thorax Online First Thorax 2006; doi 10.1136/thx.2005.053827

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Extra Wrinkles a Bad Sign for Smokers

They may point to a heightened risk for lung disease, study suggests

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, June 14 (HealthDay News) -- British scientists have discovered a tantalizing new wrinkle in our understanding of smoking's unhealthy effects.

Middle-aged smokers whose faces were heavily wrinkled were five times as likely to have chronic obstructive pulmonary disease (COPD) than smokers whose faces were relatively smooth, the study found.

The authors speculated that both COPD and wrinkling may be linked by a common mechanism and that facial wrinkling might indicate susceptibility to the potentially deadly lung disease.

It's unclear, however, what kind of clinical relevance the findings hold.

"It's certainly biologically plausible," said Dr. Norman Edelman, chief medical officer for the American Lung Association. "This may be of use in educating patients but, in terms of detection of lung disease, we [already] have a simple breathing test. We don't have to look for wrinkles."

The research appears in the June 14 online edition of Thorax, which is published by the British Medical Journal.

COPD refers to a group of progressive chronic lung diseases, including emphysema and bronchitis, that block the airways and restrict oxygen flow.

Some 13.5 million Americans suffer from COPD, and the World Health Organization predicts that the condition will become the third leading cause of death worldwide by 2020.

Smoking is the biggest risk factor for COPD, and dermatologist have long noted that smoking causes premature aging of the skin.

However, not all smokers go on to develop COPD. "Obviously, people vary in their response to what's in the smoke," Edelman said.

In the study, the team wanted to see if genetic factors that predispose smokers to COPD might also predispose them to wrinkles.

The researchers, based at Royal Devon and Exeter NHS Foundation Trust, analyzed data on 149 current and former middle-aged smokers, 68 of whom (45.6 percent) had COPD. The participants came from 78 families.

Eighty-three percent had no facial wrinkling or only minor lines, but close to 17 percent had considerable wrinkling.

Lung strength and function, measured in all participants, turned out to be significantly lower in those with extensive wrinkling than in those with smoother faces.

People with heavy wrinkles were also five times more likely to have COPD than those without wrinkles. People with facial wrinkling also had triple the risk of suffering from more severe emphysema.

The authors theorized that smoking-linked changes in cells' collagen and elastin may be important for the development of both lung disease and wrinkles.

The findings are more likely to be helpful in spurring new research than in providing any direct benefit to patients, Edelman said.

"I think this will be of use to basic biologists," he explained. "Maybe you can start doing experiments on the skin, maybe that's an easier model to use than the lung to figure out what the mechanisms are."

More information

For more on COPD, head to the American Lung Association.

SOURCES: Norman Edelman, M.D., chief medical officer, American Lung Association; June 14, 2006, Thorax online

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