Low serum levels of alpha1 anti-trypsin (α1-AT) and risk of airflow obstruction in non-primary α1-AT-deficient patients with compensated chronic liver disease.
BACKGROUND
Alpha1 anti-trypsin (α1-AT), a serine protease inhibitor synthesized in the liver, is a major circulating antiprotease that provides defense against proteolytic damage in several tissues. Its deficiency is associated with airflow obstruction. The present study aimed to explore the role of α1-AT as a biomarker of airflow performance in chronic liver disease (CLD).


METHODS
Serum α1-AT levels and lung function (spirometry) were evaluated in non-primary α1-AT-deficient, alcoholic CLD patients without evident respiratory limitations.


RESULTS
Thirty-four patients with airflow obstruction (n=11), airflow restriction (n=12), and normal airflow (n=11, age-matched controls) were eligible. α1-AT was decreased in the airflow obstruction group. ROC-cutoff α1-AT=24 mg/dL effectively discriminated airflow obstruction (AUC=0.687) and was associated with a 10-fold higher risk (p=0.0007).


CONCLUSIONS
Lower α1-AT increased the risk of airflow obstruction in CLD patients without primary α1-AT deficiency.
Department of Internal Medicine, Xoco General Hospital, and Ticomán General Hospital, Mexico City, Mexico.
Elizabeth
E
Rodríguez-Romero
Department of Internal Medicine, Xoco General Hospital, and Ticomán General Hospital, Mexico City, Mexico.
Juan Antonio
JA
Suárez-Cuenca
Department of Internal Medicine, Xoco General Hospital, and Ticomán General Hospital, Mexico City, Mexico.
César Iván
CI
Elizalde-Barrera
Biomedical Research Division, "20 de Noviembre" National Medical Centre, ISSSTE and Mexican Group for Basic and Clinical Research in Internal Medicine, Mexico City, Mexico.
Paul
P
Mondragón-Terán
Biomedical Research Division, "20 de Noviembre" National Medical Centre, ISSSTE and Mexican Group for Basic and Clinical Research in Internal Medicine, Mexico City, Mexico.
José Enrique
JE
Martínez-Hernández
Biomedical Research Division, "20 de Noviembre" National Medical Centre, ISSSTE and Mexican Group for Basic and Clinical Research in Internal Medicine, Mexico City, Mexico.
Eduardo
E
Gómez-Cortés
Department of Cellular Biology and Development, Cellular Physiology Institute, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
Rebeca
R
Pérez-Cabeza de Vaca
Department of Cellular Biology and Development, Cellular Physiology Institute, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
Rolando E
RE
Hernández-Muñoz
Department of Internal Medicine, Xoco General Hospital, and Ticomán General Hospital, Mexico City, Mexico.
Alberto
A
Melchor-López
Department of Internal Medicine, Xoco General Hospital, and Ticomán General Hospital, Mexico City, Mexico.
Nayeli Gabriela
NG
Jiménez-Saab
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D013147:Spirometry; D000515:alpha 1-Antitrypsin / Q000097:blood*; D019896:alpha 1-Antitrypsin Deficiency / Q000097:blood* / Q000150:complications / Q000503:physiopathology*
D015415:Biomarkers; D000515:alpha 1-Antitrypsin