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

Ersöz, Hilal ; Torres-Durán, María ; Turner, Alice M. ; Tanash, Hanan LU ; García, Carlota Rodríguez ; Corsico, Angelo Guido ; López-Campos, José Luis ; Miravitlles, Marc ; Clarenbach, Christian F. and Chapman, Kenneth R. , et al. (2025) In Archivos de Bronconeumologia 61(1). p.22-30
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... (More)

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 ± 10.3 u/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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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alpha1-antitrypsin, Alpha1-antitrypsin deficiency, Chronic obstructive pulmonary disease, Gender
in
Archivos de Bronconeumologia
volume
61
issue
1
pages
22 - 30
publisher
Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
external identifiers
  • pmid:39068055
  • scopus:85199770918
ISSN
0300-2896
DOI
10.1016/j.arbres.2024.06.019
language
English
LU publication?
yes
id
aba56544-9d69-473c-9f71-e6ab29bacfc8
date added to LUP
2024-11-12 10:26:18
date last changed
2025-07-09 19:15:04
@article{aba56544-9d69-473c-9f71-e6ab29bacfc8,
  abstract     = {{<p>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 &lt; 0.005 each) and consumed less alcohol (5.5 ± 7.6 vs. 8.4 ± 10.3 u/week, p &lt; 0.001). Females reported COPD (41% vs. 57%, p &lt; 0.001) and liver disease (11% vs. 20%, p &lt; 0.001) less often. However, they had a higher prevalence of bronchiectasis (24% vs. 13%, p &lt; 0.001). Despite better lung function (FEV<sub>1</sub>%pred. 73.6 ± 29.9 vs. 62.7 ± 29.5, p &lt; 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.</p>}},
  author       = {{Ersöz, Hilal and Torres-Durán, María and Turner, Alice M. and Tanash, Hanan and García, Carlota Rodríguez and Corsico, Angelo Guido and López-Campos, José Luis and Miravitlles, Marc and Clarenbach, Christian F. and Chapman, Kenneth R. and Pérez, Jose Mª Hernández and Guimarães, Catarina and Bartošovská, Eva and Greulich, Timm and Barrecheguren, Miriam and Koczulla, Andreas Rembert and Höger, Philipp and Rivera, Arturo Olivares and Herth, Felix and Trudzinski, Franziska C.}},
  issn         = {{0300-2896}},
  keywords     = {{Alpha1-antitrypsin; Alpha1-antitrypsin deficiency; Chronic obstructive pulmonary disease; Gender}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{22--30}},
  publisher    = {{Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)}},
  series       = {{Archivos de Bronconeumologia}},
  title        = {{Sex-Differences in Alpha-1 Antitrypsin Deficiency : Data From the EARCO Registry}},
  url          = {{http://dx.doi.org/10.1016/j.arbres.2024.06.019}},
  doi          = {{10.1016/j.arbres.2024.06.019}},
  volume       = {{61}},
  year         = {{2025}},
}