Sex-differences in alpha-1 antitrypsin deficiency: data from the EARCO registry
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
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
Affiliation
University of Heidelberg; German Center for Lung Research; Institute for Health Research Galicia Sur; Instituto de Salud Carlos III; University of Birmingham; University Hospitals Birmingham NHS Foundation Trust; Skåne University Hospital; Lund University; Hospital Clínico-Universitario de Santiago; Institute of Health Research of Santiago de Compostela ; University of Pavia; IRCCS Policlinico San Matteo Foundation; Hospital Universitario Virgen del Rocío; Universidad de Sevilla; Hospital Universitari Vall d'Hebron; European Reference Network on Rare Respiratory Diseases; University Hospital Zurich; University of Zurich; University of Toronto; Hospital Universitario Nuestra Señora de La Candelaria; Hospital Senhora da Oliveira; Thomayer hospital; Charles University; University Medical Centre Giessen and Marburg; Philipps-University; Schön Klinik Berchtesgadener; Thoraxklinik University of Heidelberg
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Publication date
2024-07-09
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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 (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.
Citation
Ersöz H, Torres-Durán M, Turner AM, Tanash H, Rodríguez García C, Corsico AG, López-Campos JL, Miravitlles M, Clarenbach CF, Chapman KR, Hernández Pérez JM, Guimarães C, Bartošovská E, Greulich T, Barrecheguren M, Koczulla AR, Höger P, Olivares Rivera A, Herth F, Trudzinski FC; EARCO study investigators. Sex-Differences in Alpha-1 Antitrypsin Deficiency: Data From the EARCO Registry. Arch Bronconeumol. 2025 Jan;61(1):22-30. English, Spanish. doi: 10.1016/j.arbres.2024.06.019. Epub 2024 Jul 9.
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Article