Serum Levels of Alpha1-antitrypsin and Their Relationship With COPD in the General Spanish Population |
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| Institution: | 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. Hospital La Princesa, Madrid, Spain;4. GlaxoSmithkline, Madrid, Spain;5. Institut Municipal d’Investigació Mèdica (IMIM), Barcelona, Spain;6. Hospital La Paz, Madrid, Spain;7. Hospital Universitari Vall d’Hebron, Barcelona, Spain;8. Hospital Reina Sofía, Córdoba, Spain;9. Hospital de Cruces, Bilbao, Spain;10. Fundació Caubet-CIMERA, Bunyola, Illes Balears, Spain;11. Hospital La Princesa, Madrid, Spain;12. Hospital San Jorge, Huesca, Spain;13. Hospital La Paz, Madrid, Spain;14. Hospital Central de Asturias, Oviedo, Spain;15. Hospital Virgen de la Macarena, Sevilla, Spain;p. Hospital Reina Sofía, Córdoba, Spain;q. Hospital Xeral Cies, Vigo, Spain;r. Hospital General de Vic, Vic, Barcelona, Spain;s. Hospital General de Requena, Requena, Valencia, Spain;t. Hospital Clínic, Barcelona, Spain;u. Hospital General Yagüe, Burgos, Spain;1. Grupo de Investigación de Salud Global, Universidad de Cantabria, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Cantabria, España;2. Servicio de Neumología, Hospital de Laredo, Laredo, Cantabria, España;3. Servicio de Neumología-Debilidad muscular y caquexia en las enfermedades respiratorias crónicas y el cáncer de pulmón, IMIM-Hospital del Mar, Barcelona, España;4. Departament de Ciències Experimentals i de la Salut (CEXS), Universitat Pompeu Fabra (UPF), Parc de Recerca Biomédica de Barcelona (PRBB), Barcelona, España;5. Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, España;1. Grupo NeumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS). Servicio de Neumología, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, España;2. Área de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela. Servicio de Medicina Preventiva, Hospital Clínico Universitario de Santiago de Compostela. CIBER de Epidemiología y Salud Pública (CIBERESP), Santiago de Compostela, La Coruña, España;1. Respiratory Diseases, University of Bari, Italy;2. Respiratory Diseases, University of Foggia, Italy;3. Fallacara Hospital, Triggiano, Italy;1. Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela;2. Universidad de la República, Hospital Maciel, Montevideo, Uruguay;3. Departamento de Investigación y Estadística, ITSalud/Medsolid, Caracas, Venezuela;4. SubSecretaría de Planificación Sanitaria, Ministerio de Salud, Gobierno de la Ciudad Autónoma de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina;5. Fundación Neumológica Colombiana, Bogotá, Colombia;6. Hospital Central Fuerza Aérea del Perú, Lima, Perú;7. Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, México;8. Hospital Rodolfo Rossi, La Plata, Argentina;9. Universidade do Estado da Bahia e Escola Bahiana de Medicina, Salvador, Brasil;10. Hospital Dr. Antonio Cetrángolo, Vicente López, Buenos Aires, Argentina;11. Hospital Centro Médico, Guatemala, Guatemala;12. Hospital José Gregorio Hernández, Caracas, Venezuela;13. Clínica Alemana de Santiago, Hospital Padre Hurtado, Universidad del Desarrollo, San Ramón, Región Metropolitana, Chile;14. Escuela de Medicina, Universidad de Valparaíso, Hospital C. Van Buren, Valparaíso, Región de Valparaíso, Chile |
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| Abstract: | BackgroundLow 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.MethodsThis 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.ResultsIn 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.ConclusionIncreased 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. |
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| Keywords: | Alpha1-antitrypin Acute phase reactants COPD Lung function Respiratory symptoms Alfa-1 antitripsina Reactantes de fase aguda EPOC Función pulmonar Síntomas respiratorios |
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