Elsevier

Respiratory Medicine

Volume 103, Issue 6, June 2009, Pages 861-865
Respiratory Medicine

Lung function in 30-year-old alpha-1-antitrypsin-deficient individuals

https://doi.org/10.1016/j.rmed.2008.12.021Get rights and content
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Summary

Background

Alpha-1-antitrypsin (AAT) deficiency increases the risk of emphysema, especially in smokers. In 1972–1974, all 200,000 Swedish new-born infants were screened for AAT deficiency and individuals with severe (PiZZ) and moderate (PiSZ) deficiency have been followed-up regularly. The aim of the present study was to examine their lung function at the age of 30 years, comparing them to a group of age-matched control subjects (PiMM) recruited from the general population, and to compare current smokers with never-smokers.

Method

Static and dynamic spirometry, including TLC, FRC, RV, VC, FEV1,KCO and DL,CO, was performed for all participants. All values were expressed as percentages of the expected values. FEV1/VC was expressed both as percentage of the expected value and in absolute numbers.

Results

Four of 60 PiZZ, none of 19 PiSZ and 9 of 33 PiMM participating individuals were current smokers. All Pi groups had a normal mean FEV1. The mean (SD) FEV1/VC ratio was 75% (7.4) in the PiZZ smokers and 84% (5.5) in the PiZZ never-smokers (p < 0.01). The mean (SD) KCO was 81 (13) in the PiZZ smokers and 99 (14) in the PiZZ never-smokers (p < 0.05).

Conclusion

AAT-deficient individuals identified by neonatal screening have normal lung function at the age of 30. The PiZZ smokers had changes in lung function that may be signs of early emphysema.

Keywords

Chronic obstructive pulmonary disease
Alpha-1-antitrypsin deficiency
Pulmonary function
Smoking

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