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慢性阻塞性肺疾病(COPD)的两个易感性变异体是中国患者肺气肿和胸部计算机断层扫描表现的遗传决定因素。

Two susceptibility variants for COPD are genetic determinants of emphysema and chest computed tomography manifestations in Chinese patients.

作者信息

Zhao Zhuxiang, Jiang Changbin, Zhao Dongxing, Li Yujun, Liang Chunxiao, Liu Weifeng, Wei Shuquan, Zhou Yumin, Zhao Ziwen, Ran Pixin

机构信息

The State Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou.

The Pulmonary Medicine,Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.

出版信息

Int J Chron Obstruct Pulmon Dis. 2017 May 15;12:1447-1455. doi: 10.2147/COPD.S134010. eCollection 2017.

Abstract

Quantitative computed tomography (CT) measures of emphysema have been shown to be associated with increased mortality in humans, but genetic variants affecting the quantitative parameters of chest CT that measure degree of emphysema have not yet been examined. In this study, using available chest CT data from a total of 344 emphysema patients, we assessed the correlations between five chronic obstructive pulmonary disease (COPD) susceptibility variants in the cholinergic receptor nicotinic () genes and the degree of emphysema and chest CT manifestations. We verified that most of the parameters were significantly correlated with the degree of emphysema. Compared to rs76071148AA and TT genotype carriers, the rs76071148AT genotype carriers exhibited a decreased probability of having severe emphysema (odds ratio [OR] =0.63, 95% confidence interval [CI] =0.40-0.99), whereas the variant rs8040868C allele was negatively correlated with the emphysema index (=0.002). Interestingly, further stratification analysis grouped by spirometry-diagnosed COPD status revealed that the variant rs8040868C (CT + CC) genotypes exerted a protective effect against severe emphysema with borderline significance (OR =0.41, 95% CI =0.16-1.05) and affected the mean lung density, emphysema index, ratio of airway wall thickness to airway dimensions (AWT/AD), and AWT grade in spirometry-diagnosed non-COPD subjects. The rs76071148 variant was also significantly associated with AWT/AD and AWT grade in those individuals. In summary, we determined that rs8040868 and rs76071148 are promising indicators of the degree of emphysema and chest CT manifestations, especially in spirometry-diagnosed non-COPD subjects.

摘要

定量计算机断层扫描(CT)对肺气肿的测量已被证明与人类死亡率增加相关,但影响测量肺气肿程度的胸部CT定量参数的基因变异尚未得到研究。在本研究中,我们利用来自344例肺气肿患者的现有胸部CT数据,评估了胆碱能受体烟碱型()基因中的五个慢性阻塞性肺疾病(COPD)易感变异与肺气肿程度及胸部CT表现之间的相关性。我们证实大多数参数与肺气肿程度显著相关。与rs76071148AA和TT基因型携带者相比,rs76071148AT基因型携带者发生严重肺气肿的概率降低(优势比[OR]=0.63,95%置信区间[CI]=0.40-0.99),而变异rs8040868C等位基因与肺气肿指数呈负相关(=-0.002)。有趣的是,根据肺功能测定诊断的COPD状态进行的进一步分层分析显示,变异rs8040868C(CT+CC)基因型对严重肺气肿具有保护作用,具有临界显著性(OR=0.41,95%CI=0.16-1.05),并影响肺功能测定诊断的非COPD受试者的平均肺密度、肺气肿指数、气道壁厚度与气道尺寸之比(AWT/AD)及AWT分级。rs76071148变异在这些个体中也与AWT/AD及AWT分级显著相关。总之,我们确定rs8040868和rs76071148是肺气肿程度及胸部CT表现的有前景的指标,尤其是在肺功能测定诊断的非COPD受试者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c26b/5439970/09138a148b27/copd-12-1447Fig1.jpg

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