α1抗胰蛋白酶缺乏症的性别差异：来自EARCO注册中心的数据。

Sex-Differences in Alpha-1 Antitrypsin Deficiency: Data From the EARCO Registry.

作者信息

Ersöz Hilal, Torres-Durán María, Turner Alice M, Tanash Hanan, Rodríguez García Carlota, Corsico Angelo Guido, López-Campos José Luis, Miravitlles Marc, Clarenbach Christian F, Chapman Kenneth R, Hernández Pérez José M, Guimarães Catarina, Bartošovská Eva, Greulich Timm, Barrecheguren Miriam, Koczulla Andreas Rembert, Höger Philipp, Olivares Rivera Arturo, Herth Felix, Trudzinski Franziska C

机构信息

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.

Pneumology Service Hospital Alvaro Cunqueiro, Vigo, Institute for Health Research Galicia Sur (IISGS), Vigo, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Arch Bronconeumol. 2025 Jan;61(1):22-30. doi: 10.1016/j.arbres.2024.06.019. Epub 2024 Jul 9.

DOI:10.1016/j.arbres.2024.06.019

PMID:39068055

Abstract

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 (FEV%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.

摘要

背景

性别影响慢性阻塞性肺疾病（COPD）的多个方面。关于α-1抗胰蛋白酶缺乏症（AATD）这一主题的数据有限。因此，我们旨在EARCO注册研究中调查性别问题，这是一项前瞻性、国际性、观察性队列研究。

方法

对登记在册且有完整性别和吸烟史数据的PiZZ个体的基线数据进行组间比较和二元逻辑回归分析。

结果

分析了1283例AATD患者，其中女性占49.3%。女性报告的烟草消费量较少（16.8±12.2对19.6±14.5包年，p = 0.006），职业性接触气体、粉尘或石棉的情况较少（每项p<0.005），饮酒量也较少（5.5±7.6对8.4±10.3单位/周，p<0.001）。女性报告患COPD（41%对57%，p<0.001）和肝病（11%对20%，p<0.001）的情况较少。然而，她们患支气管扩张的患病率较高（24%对13%，p<0.001）。尽管女性肺功能较好（FEV%预计值73.6±29.9对62.7±29.5，p<0.001），但与男性相比，她们报告的症状负担（CAT 13.4±9.5对12.5±8.9，p = 无显著差异）和急性加重频率（前一年至少一次30%对26%，p = 无显著差异）相似。在多变量分析中，除吸烟史、COPD、哮喘和支气管扩张外，女性性别是前一年急性加重的独立危险因素，比值比为1.6，p = 0.001，并且除年龄、BMI、COPD和吸烟史外，女性性别还被确定为症状负担（CAT≥10）的危险因素，比值比为1.4，p = 0.014。