title: Lung Function and CT Densitometry in Subjects with alpha-1-Antitrypsin Deficiency and Healthy Controls at 35 Years of Age.
abstract: Alpha-1-antitrypsin (AAT) deficiency is a genetic risk factor for pulmonary emphysema. In 1972-74 all 200,000 Swedish new-born infants were screened for AAT deficiency. The aim of the present study was to investigate whether the PiZZ and PiSZ individuals identified by this screening have signs of emphysema and the role of smoking in this, compared with a random sample of control subjects at 35 years of age. The study participants underwent complete pulmonary function tests (PFT) and CT densitometry. The fifteenth percentile density (PD15) and the relative area below -910 HU (RA-910) were analyzed. Fifty-four PiZZ, 21 PiSZ and 66 PiMM control subjects participated in the study. No significant differences were found in lung function between the never-smoking AAT-deficient and control subjects. The 16 PiZZ ever-smokers had significantly lower carbon monoxide transfer coefficient (KCO) than the 20 PiSZ never-smokers (p = 0.014) and the 44 PiMM never-smokers (p = 0.005). After correction for the CT derived lung volume, the PiZZ ever-smokers had significantly lower PD15 (p = 0.046) than the ever-smoking controls. We conclude that 35-year-old PiZZ and PiSZ never-smokers have normal lung function when compared with never-smoking control subjects. The differences in KCO and CT densitometric parameters between the PiZZ ever-smokers and the control subjects may indicate early signs of emphysema.
authors.affiliation: 1Departments of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University , Malmö , Sweden.
authors.forename: Eeva
authors.initials: E
authors.lastname: Piitulainen
authors.forename: Laura Cano
authors.initials: LC
authors.lastname: Montero
authors.forename: Meltem
authors.initials: M
authors.lastname: Nystedt-Düzakin
authors.forename: Berend C
authors.initials: BC
authors.lastname: Stoel
authors.forename: Tomas
authors.initials: T
authors.lastname: Sveger
authors.forename: Per
authors.initials: P
authors.lastname: Wollmer
authors.forename: Hanan A
authors.initials: HA
authors.lastname: Tanash
authors.forename: Sandra
authors.initials: S
authors.lastname: Diaz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003720:Densitometry / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D061330:Multidetector Computed Tomography; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012907:Smoking / Q000009:adverse effects; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: COPD; CT densitometry; alpha-1-antitrypsin deficiency; lung function