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

• Hilal Ersöz ^[6] ; María Torres Durán ^[7] ; Alice M. Turner ^[8] ; Hanan Tanash ^[9] ; Carlota Rodríguez García ^[10] ; Angelo Guido Corsico ^[1] ; José Luis López Campos ^[2] ; Marc Miravitlles ^[11] ; Christian F. Clarenbach ^[12] ; Kenneth R. Chapman ^[3] ; José M. Hernández Pérez ^[13] ; Catarina Guimarães ^[14] ; Eva Bartošovská ^[4] ; Timm Greulich ^[15] ; Miriam Barrecheguren ^[11] ; Andreas Rembert Koczulla ^[5] ; Philipp Höger ^[6] ; Arturo Olivares Rivera ^[6] ; Felix Herth ^[6] ; Franziska C. Trudzinski ^[6]
  1. [1] University of Pavia

     University of Pavia

     Pavía, Italia

     
  2. [2] Instituto de Biomedicina de Sevilla

     Instituto de Biomedicina de Sevilla

     Sevilla, España

     
  3. [3] University of Toronto

     University of Toronto

     Canadá

     
  4. [4] Charles University in Prague

     Charles University in Prague

     Chequia

     
  5. [5] Philipp University of Marburg

     Philipp University of Marburg

     Landkreis Marburg-Biedenkopf, Alemania

     
  6. [6] Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Heidelberg, Germany
  7. [7] Pneumology Service Hospital Alvaro Cunqueiro, Vigo, Institute for Health Research Galicia Sur (IISGS), Vigo, Spain
  8. [8] Institute for Applied Health Research, University of Birmingham, Birmingham B15 2TT, United Kingdom
  9. [9] Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Malmö, Sweden
  10. [10] Department of Pulmonology, Hospital Clínico-Universitario de Santiago, Santiago de Compostela, Spain
  11. [11] Pneumology Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus – Health Care Provider of the European Reference Network on Rare Respiratory Diseases (ERN LUNG), Barcelona, Spain
  12. [12] Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
  13. [13] Pneumology Department, Hospital Universitario Nuestra Señora de La Candelaria, Santa Cruz de Tenerife, Spain
  14. [14] Pulmonology Department,Hospital Senhora da Oliveira, Guimarães, Portugal
  15. [15] University Medical Centre Giessen and Marburg, Philipps-University, Deparment of Medicine, Pulmonary and Critical Care Medicine, Member of the German Centre for Lung Research (DZL), Marburg, Germany

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 61, Nº. 1, 2025, págs. 22-30
• Idioma: inglés
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• Resumen

  • 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.