Research

Circulating alpha1-antitrypsin in the general population: Determinants and association with lung function

Oliver Senn¹ , Erich W Russi² , Christian Schindler³ , Medea Imboden^1,6 , Arnold von Eckardstein⁴ , Otto Brändli⁵ , Elisabeth Zemp³ , Ursula Ackermann-Liebrich³ , Wolfgang Berger⁶ , Thierry Rochat⁷ , Maurizio Luisetti⁸ , Nicole M Probst-Hensch¹ and the SAPALDIA Team

¹Molecular Epidemiology/Cancer Registry, Institutes of Social and Preventive Medicine & Clinical Pathology, University of Zurich, Zürich, Switzerland

²Pulmonary Division, University Hospital of Zurich, Zürich, Switzerland

³Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland

⁴Institute of Clinical Chemistry, University Hospital of Zurich, Zürich, Switzerland

⁵Zürcher Höhenklinik Wald, Wald, Switzerland

⁶Division of Medical Molecular Genetics and Gene Diagnostics, Institute of Medical Genetics, University of Zurich, Schwerzenbach, Switzerland

⁷Division of Pulmonary Medicine, University Hospital of Geneva, Geneva, Switzerland

⁸Clinica di Malattie dell'Apparato Respiratorio, Laboratorio di Biochimica e Genetica, IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy

author email corresponding author email

Respiratory Research 2008, 9:35doi:10.1186/1465-9921-9-35

Published:	25 April 2008

Abstract

Background

Severe alpha1-antitrypsin (AAT) deficiency associated with low AAT blood concentrations is an established genetic COPD risk factor. Less is known about the respiratory health impact of variation in AAT serum concentrations in the general population. We cross-sectionally investigated correlates of circulating AAT concentrations and its association with FEV1.

Methods

In 5187 adults (2669 females) with high-sensitive c-reactive protein (CRP) levels ≤ 10 mg/l from the population-based Swiss SAPALDIA cohort, blood was collected at the time of follow-up examination for measuring serum AAT and CRP.

Results

Female gender, hormone intake, systolic blood pressure, age in men and in postmenopausal women, as well as active and passive smoking were positively, whereas alcohol intake and BMI inversely correlated with serum AAT levels, independent of CRP adjustment. We observed an inverse association of AAT with FEV1 in the total study population (p < 0.001), that disappeared after adjustment for CRP (p = 0.28). In addition, the AAT and FEV1 association was modified by gender, menopausal status in women, and smoking.

Conclusion

The results of this population-based study reflect a complex interrelationship between tobacco exposure, gender related factors, circulating AAT, systemic inflammatory status and lung function.