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Risk Factors for Reduced Pulmonary Function in Women

1992; Elsevier BV; Volume: 102; Issue: 1 Linguagem: Inglês

10.1378/chest.102.1.158

1931-3543

Sandra L. Horne, Yue Chen, Donald W. Cockcroft, James A. Dosman,

Pulmonary Hypertension Research and Treatments

Smoking and severe deficiency of protease inhibitor (Pi Z phenotype) both contribute significantly to the development of chronic obstructive pulmonary disease (COPD). The role of moderate Pi deficiency (Pi MZ phenotype) remains controversial. During a community-wide study of respiratory health which included 1,633 individuals, of whom 897 were women, we measured forced vital capacity (FVC), forced expired flow in 1 s (FEV1), midmaximum expired flow rate (MMFR), flow rate at 50 percent of FVC ( V ˙ max 50 % ) and flow rate at 25 percent of FVC above residual volume ( V ˙ max 25 % ). We carried out Pi phenotyping on 544 of these women, including 22 who were Pi MZ or FZ phenotypes. There were no statistically significant differences in mean pulmonary function (pf) values between the Pi MZ and Pi M women. Examination of residual pf values (difference between observed and expected) by means of multiple multivariate regression analysis revealed that in Pi MZ women, FEV1/FVC%, MMFR, V ˙ max 50 % , and V ˙ max 25 % had significantly greater values with increasing numbers of children, whereas there was no relationship in the Pi M women. These results suggest that some factors may interact differently in individuals with Pi M and MZ phenotypes. In addition, the results suggest that pregnancy or pregnancy-induced increased Pi levels may have significant effects on the pulmonary health of Pi MZ women. (Chest 1992; 102:158–63) Smoking and severe deficiency of protease inhibitor (Pi Z phenotype) both contribute significantly to the development of chronic obstructive pulmonary disease (COPD). The role of moderate Pi deficiency (Pi MZ phenotype) remains controversial. During a community-wide study of respiratory health which included 1,633 individuals, of whom 897 were women, we measured forced vital capacity (FVC), forced expired flow in 1 s (FEV1), midmaximum expired flow rate (MMFR), flow rate at 50 percent of FVC ( V ˙ max 50 % ) and flow rate at 25 percent of FVC above residual volume ( V ˙ max 25 % ). We carried out Pi phenotyping on 544 of these women, including 22 who were Pi MZ or FZ phenotypes. There were no statistically significant differences in mean pulmonary function (pf) values between the Pi MZ and Pi M women. Examination of residual pf values (difference between observed and expected) by means of multiple multivariate regression analysis revealed that in Pi MZ women, FEV1/FVC%, MMFR, V ˙ max 50 % , and V ˙ max 25 % had significantly greater values with increasing numbers of children, whereas there was no relationship in the Pi M women. These results suggest that some factors may interact differently in individuals with Pi M and MZ phenotypes. In addition, the results suggest that pregnancy or pregnancy-induced increased Pi levels may have significant effects on the pulmonary health of Pi MZ women. (Chest 1992; 102:158–63)