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Serum Alpha-1 Antitrypsin Levels and the Clinical Course of Chronic Obstructive Pulmonary Disease

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Title: Serum Alpha-1 Antitrypsin Levels and the Clinical Course of Chronic Obstructive Pulmonary Disease
Authors: Takei, Nozomu Browse this author
Suzuki, Masaru Browse this author →KAKEN DB
Makita, Hironi Browse this author →KAKEN DB
Konno, Satoshi Browse this author →KAKEN DB
Shimizu, Kaoruko Browse this author →KAKEN DB
Kimura, Hiroki Browse this author →KAKEN DB
Kimura, Hirokazu Browse this author
Nishimura, Masaharu Browse this author →KAKEN DB
Keywords: chronic obstructive pulmonary disease
alpha-1 antitrypsin
inflammation
lung function decline
mortality
Issue Date: 10-Dec-2019
Publisher: Dove Medical Press
Journal Title: International journal of chronic obstructive pulmonary disease
Volume: 14
Start Page: 2885
End Page: 2893
Publisher DOI: 10.2147/COPD.S225365
Abstract: Purpose: Alpha-1 antitrypsin deficiency is associated with the development of chronic obstructive pulmonary disease (COPD), whereas increased levels of serum alpha-1antitrypsin occur in response to inflammation. The effects of alpha-1 antitrypsin levels on the clinical course of COPD had been unclear. We investigated the association of serum alpha-1 antitrypsin levels with the clinical course of COPD patients based on data from a 10-year prospective cohort study. Patients and methods: We analyzed 278 COPD patients who participated in the Hokkaido COPD cohort study and who did not meet the criteria for alpha-1 antitrypsin deficiency. We divided the subjects into 3 groups according to quartiles of serum alpha-1 antitrypsin levels at baseline: lower group (<116 mg/dL, n = 66); middle group (116 to <= 141 mg/dL, n = 145); and higher group (>141 mg/dL, n = 67). The annual change in forced expiratory volume in 1 s (FEV1) and events of COPD exacerbation were monitored during the first 5 years, and mortality was followed-up during the entire 10 years. Results: At baseline, the higher group showed lower body mass index; higher computed tomography emphysema score; lower diffusing capacity; higher levels of acute-phase proteins; and higher blood neutrophil counts. Longitudinal analyses revealed that in the higher group, the annual decline in FEV1 was rapid and the 10-year mortality was higher, but there was no association between serum alpha-1 antitrypsin levels and time to first exacerbation. Conclusion: COPD subjects with higher serum alpha-1 antitrypsin levels were associated with a worse systemic inflammation status and higher 10-year mortality.
Rights: https://creativecommons.org/licenses/by-nc/3.0/
Type: article
URI: http://hdl.handle.net/2115/76623
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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