title: Smoking related COPD and facial wrinkling: is there a common susceptibility?
abstract: BACKGROUND
  Cigarette smoking causes accelerated facial wrinkling and predisposes to chronic obstructive pulmonary disease (COPD). However, it has long been recognised that there is a subgroup of susceptible smokers who are at increased risk of developing airflow obstruction. We have tested the hypothesis that there is a common susceptibility for the development of COPD and facial wrinkling in cigarette smokers.
  
  
  METHODS
  One hundred and forty nine current and ex-smokers were recruited from a family based study of COPD genetics, 68 (45.6%) of whom fulfilled the definition of COPD. 124 (83.2%) had no or minor facial wrinkling (Daniell <IV) and 25 (16.8%) were wrinkled (Daniell score >/=IV). Generalised estimating equations were used to adjust for familial correlations between related individuals and the potential confounding effects of age and pack years smoked.
  
  
  RESULTS
  Forced expiratory volume in 1 second (FEV(1)) was significantly lower in those with wrinkles than in those without (mean difference in FEV(1) % predicted -13.7%, 95% CI -27.5 to 0.0, p = 0.05) and facial wrinkling was associated with a substantially increased risk of COPD (adjusted OR 5.0, 95% CI 1.3 to 18.5, p<0.02). The Daniell score correlated with the extent of emphysema on the CT scan (p<0.05) and facial wrinkling was also associated with a greater risk of more extensive emphysema (adjusted OR 3.0, 95% CI 1.0 to 9.3, p = 0.05).
  
  
  CONCLUSIONS
  Facial wrinkling is associated with COPD in smokers, and both disease processes may share a common susceptibility. Facial wrinkling in smokers may therefore be a biomarker of susceptibility to COPD.
authors.affiliation: Department of Public Health and Primary Care, University of Cambridge, UK. Bip.Patel@rdehc-tr.swest.nhs.uk
authors.forename: B D
authors.initials: BD
authors.lastname: Patel
authors.forename: W J
authors.initials: WJ
authors.lastname: Loo
authors.forename: A D
authors.initials: AD
authors.lastname: Tasker
authors.forename: N J
authors.initials: NJ
authors.lastname: Screaton
authors.forename: N P
authors.initials: NP
authors.lastname: Burrows
authors.forename: E K
authors.initials: EK
authors.lastname: Silverman
authors.forename: D A
authors.initials: DA
authors.lastname: Lomas
mesh_terms: D004198:Disease Susceptibility; D005145:Face / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000473:pathology; D015595:Skin Aging / Q000473:pathology; D012907:Smoking / Q000009:adverse effects*