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Arch Bronconeumol. 2019 May 29. pii: S0300-2896(19)30112-7. doi: 10.1016/j.arbres.2019.03.001. [Epub ahead of print]

Serum Levels of Alpha1-antitrypsin and Their Relationship With COPD in the General Spanish Population.

[Article in English, Spanish]

Author information

1
Department of Respiratory Medicine, Hannover Medical School, Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Member of German Centre for Lung Research (DZL), Hannover, Germany.
2
Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
3
Pneumology Department, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. Electronic address: miravitlles@vhebron.net.
4
Hospital La Princesa, Madrid, Spain.
5
GlaxoSmithkline, Madrid, Spain.
6
Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain.
7
Hospital La Paz, Madrid, Spain.
8
Hospital Universitari Vall d'Hebron, Barcelona, Spain.
9
Hospital Reina Sofía, Córdoba, Spain.
10
Hospital de Cruces, Bilbao, Spain.
11
Fundació Caubet-CIMERA, Bunyola, Illes Balears, Spain.
12
Hospital San Jorge, Huesca, Spain.
13
Hospital Central de Asturias, Oviedo, Spain.
14
Hospital Virgen de la Macarena, Sevilla, Spain.
15
Hospital Xeral Cies, Vigo, Spain.
16
Hospital General de Vic, Vic, Barcelona, Spain.
17
Hospital General de Requena, Requena, Valencia, Spain.
18
Hospital Clínic, Barcelona, Spain.
19
Hospital General Yagüe, Burgos, Spain.

Abstract

BACKGROUND:

Low plasma level of alpha1-antitrypsin (AAT) is an established risk factor for early-onset chronic obstructive lung disease (COPD). However, less attention is given to the levels of AAT in the general population.

METHODS:

This is a part of a multicentre, population-based study conducted at 11 sites throughout Spain. Plasma levels of AAT were available for 837 persons with a mean (SD) age of 58.05 (11.3) years: 328-smokers, 272-ex-smokers and 237 non-smokers. Out of 837, 303 (36.2%) had a diagnosis of COPD, 222 (26.5%) had respiratory symptoms but no COPD, and 312 (37.3%) were healthy controls.

RESULTS:

In the whole cohort, the mean level of plasma AAT was 1.51 (0.47)g/L. Levels were higher in COPD patients [1.55 (0.45)g/L] and individuals with respiratory symptoms [1.57 (0.47)g/L] than in controls [1.43 (0.47)g/L], p<0.001, a finding which persisted after correction for age and CRP. Plasma AAT levels were negatively associated with FEV1/FVC ratio, after adjustment for age, sex, smoking status, CRP, TNFα, fibrinogen and albumin. The risk for COPD was significantly associated with higher AAT levels in univariate and multivariate models, with odds ratios of 1.8 and 1.5, respectively. In the univariate and multivariate models smoking status, gender, and CRP levels were also associated with COPD probability, demonstrating that they act independently.

CONCLUSION:

Increased circulating levels of AAT, similarly to CRP and other markers of systemic inflammation, is an important feature of COPD. Our results highlight a complex interrelationship between levels of AAT and health of respiratory system.

KEYWORDS:

Acute phase reactants; Alfa-1 antitripsina; Alpha1-antitrypin; COPD; EPOC; Función pulmonar; Lung function; Reactantes de fase aguda; Respiratory symptoms; Síntomas respiratorios

PMID:
31153743
DOI:
10.1016/j.arbres.2019.03.001
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