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Sex-Differences in Alpha-1 Antitrypsin Deficiency: Data From the EARCO Registry
H. Ersöz, M. Torres-Durán, AM. Turner, H. Tanash, C. Rodríguez García, AG. Corsico, JL. López-Campos, M. Miravitlles, CF. Clarenbach, KR. Chapman, JM. Hernández Pérez, C. Guimarães, E. Bartošovská, T. Greulich, M. Barrecheguren, AR. Koczulla, P....
Language xxx, English Country Spain
Document type Journal Article, Observational Study, Multicenter Study, Comparative Study
NLK
Free Medical Journals
from 2000
ROAD: Directory of Open Access Scholarly Resources
from 1998
- MeSH
- Bronchiectasis epidemiology etiology MeSH
- Pulmonary Disease, Chronic Obstructive epidemiology etiology MeSH
- alpha 1-Antitrypsin Deficiency * epidemiology complications MeSH
- Comorbidity MeSH
- Smoking epidemiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Liver Diseases epidemiology etiology MeSH
- Alcohol Drinking epidemiology MeSH
- Occupational Exposure adverse effects MeSH
- Prevalence MeSH
- Prospective Studies MeSH
- Registries * MeSH
- Aged MeSH
- Sex Factors MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Comparative Study MeSH
BACKGROUND: Sex and gender influence many aspects of chronic obstructive pulmonary disease (COPD). Limited data are available on this topic in alpha-1 antitrypsin deficiency (AATD). We therefore aimed to investigate sex issues in the EARCO registry, a prospective, international, observational cohort study. METHODS: Baseline data from PiZZ individuals, enrolled in the registry with complete data on sex and smoking history were analysed by group comparisons and binary logistic regression analyses. RESULTS: 1283 patients with AATD, 49.3% women were analysed. Females reported less tobacco consumption (16.8±12.2 vs. 19.6±14.5 PY, p=0.006), occupational exposures towards gases, dusts or asbestos (p<0.005 each) and consumed less alcohol (5.5±7.6 vs. 8.4±10.3u/week, p<0.001). Females reported COPD (41% vs. 57%, p<0.001) and liver disease (11% vs. 20%, p<0.001) less often. However, they had a higher prevalence of bronchiectasis (24% vs. 13%, p<0.001). Despite better lung function (FEV1%pred. 73.6±29.9 vs. 62.7±29.5, p<0.001) females reported a similar symptom burden (CAT 13.4±9.5 vs. 12.5±8.9, p=ns) and exacerbation frequency (at least one in the previous year 30% vs. 26%, p=ns) compared to males. In multivariate analyses, female sex was an independent risk factor for exacerbations in the previous year OR 1.6 p=0.001 in addition to smoking history, COPD, asthma and bronchiectasis and was also identified as risk factors for symptom burden (CAT≥10) OR 1.4 p=0.014 besides age, BMI, COPD and smoking history. CONCLUSION: Men had higher rates of COPD and liver disease, women were more likely to have bronchiectasis. Women's higher symptom burden and exacerbation frequency suggest they may need tailored treatment approaches.
Department of Internal Medicine and Therapeutics University of Pavia Italy
Department of Pulmonology Hospital Clínico Universitario de Santiago Santiago de Compostela Spain
Department of Pulmonology University Hospital Zurich Zurich Switzerland
Faculty of Medicine University of Zurich Zurich Switzerland
Institute for Applied Health Research University of Birmingham Birmingham B15 2TT United Kingdom
Pulmonology Department Hospital Senhora da Oliveira Guimarães Portugal
Respiratory Diseases Division IRCCS Policlinico San Matteo Foundation Pavia Italy
Schön Klinik Berchtesgadener PMU Salzburg Austria
Thomayer hospital Charles University Prague Czech Republic
Translational Lung Research Center Heidelberg Heidelberg Germany
University Hospitals Birmingham NHS Foundation Trust Birmingham United Kingdom
References provided by Crossref.org
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- $a Ersöz, Hilal $u Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Heidelberg, Germany
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- $a BACKGROUND: Sex and gender influence many aspects of chronic obstructive pulmonary disease (COPD). Limited data are available on this topic in alpha-1 antitrypsin deficiency (AATD). We therefore aimed to investigate sex issues in the EARCO registry, a prospective, international, observational cohort study. METHODS: Baseline data from PiZZ individuals, enrolled in the registry with complete data on sex and smoking history were analysed by group comparisons and binary logistic regression analyses. RESULTS: 1283 patients with AATD, 49.3% women were analysed. Females reported less tobacco consumption (16.8±12.2 vs. 19.6±14.5 PY, p=0.006), occupational exposures towards gases, dusts or asbestos (p<0.005 each) and consumed less alcohol (5.5±7.6 vs. 8.4±10.3u/week, p<0.001). Females reported COPD (41% vs. 57%, p<0.001) and liver disease (11% vs. 20%, p<0.001) less often. However, they had a higher prevalence of bronchiectasis (24% vs. 13%, p<0.001). Despite better lung function (FEV1%pred. 73.6±29.9 vs. 62.7±29.5, p<0.001) females reported a similar symptom burden (CAT 13.4±9.5 vs. 12.5±8.9, p=ns) and exacerbation frequency (at least one in the previous year 30% vs. 26%, p=ns) compared to males. In multivariate analyses, female sex was an independent risk factor for exacerbations in the previous year OR 1.6 p=0.001 in addition to smoking history, COPD, asthma and bronchiectasis and was also identified as risk factors for symptom burden (CAT≥10) OR 1.4 p=0.014 besides age, BMI, COPD and smoking history. CONCLUSION: Men had higher rates of COPD and liver disease, women were more likely to have bronchiectasis. Women's higher symptom burden and exacerbation frequency suggest they may need tailored treatment approaches.
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