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      Body height as risk factor for emphysema in COPD

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          Pulmonary emphysema is a phenotypic component of chronic obstructive pulmonary disease (COPD) which carries substantial morbidity and mortality. We explored the association between emphysema and body height in 726 patients with COPD using computed tomography as the reference diagnostic standard for emphysema. We applied univariate analysis to look for differences between patients with emphysema and those without, and multivariate logistic regression to identify significant predictors of the risk of emphysema. As covariates we included age, sex, body height, body mass index, pack-years of smoking, and forced expiratory volume in one second (FEV 1) as percent predicted. The overall prevalence of emphysema was 52%. Emphysemic patients were significantly taller and thinner than non-emphysemic ones, and featured significantly higher pack-years of smoking and lower FEV 1 (P < 0.001). The prevalence of emphysema rose linearly by 10-cm increase in body height (r 2 = 0.96). In multivariate analysis, the odds of emphysema increased by 5% (95% confidence interval, 3 to 7%) along with one-centimeter increase in body height, and remained unchanged after adjusting for all the potential confounders considered (P < 0.001). The odds of emphysema were not statistically different between males and females. In conclusion, body height is a strong, independent risk factor for emphysema in COPD.

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          Most cited references 30

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            Alpha1-antitrypsin deficiency.

            Alpha1-antitrypsin deficiency is a genetic disorder that affects about one in 2000-5000 individuals. It is clinically characterised by liver disease and early-onset emphysema. Although alpha1 antitrypsin is mainly produced in the liver, its main function is to protect the lung against proteolytic damage from neutrophil elastase. The most frequent mutation that causes severe alpha1-antitrypsin deficiency arises in the SERPINA 1 gene and gives rise to the Z allele. This mutation reduces concentrations in serum of alpha1 antitrypsin by retaining polymerised molecules within hepatocytes: an amount below the serum protective threshold of 11 micromol/L increases risk for emphysema. In addition to the usual treatments for emphysema, infusion of purified alpha1 antitrypsin from pooled human plasma represents a specific treatment and raises the concentrations in serum and epithelial-lining fluid above the protective threshold. Evidence suggests that this approach is safe, slows the decline of lung function, could reduce infection rates, and might enhance survival. However, uncertainty about the cost-effectiveness of this expensive treatment remains.
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                Author and article information

                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group
                22 November 2016
                : 6
                [1 ]Department of Experimental and Clinical Medicine, University of Florence , 50134 Florence, Italy
                [2 ]Unit of Biostatistics, Department of Environmental Medicine, Karolinska Institutet , 17177 Stockholm, Sweden
                [3 ]Institute of Clinical Physiology, National Research Council of Italy , 56124 Pisa, Italy
                [4 ]“Gabriele Monasterio” Tuscany Foundation , 56124 Pisa, Italy
                Author notes
                Copyright © 2016, The Author(s)

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