Early-onset chronic obstructive pulmonary disease is associated with female sex, maternal factors, and African American race in the COPDGene study

Marilyn G. Foreman, Lening Zhang, James Murphy, Nadia N. Hansel, Barry Make, John E. Hokanson, George Washko, Elizabeth A. Regan, James D. Crapo, Edwin K. Silverman, Dawn L. DeMeo

Research output: Contribution to journalArticle

Abstract

Rationale: The characterization of young adults who develop late-onset diseases may augment the detection of novel genes and promote new pathogenic insights. Methods: We analyzed data from 2,500 individuals of African and European ancestry in the COPDGene Study. Subjects with severe, early-onset chronic obstructive pulmonary disease (COPD) (n = 70, age < 55 yr, FEV1 < 50% predicted) were compared with older subjects with COPD (n = 306, age > 64 yr, FEV1 < 50% predicted). Measurements and Main Results: Subjects with severe, early-onset COPD were predominantly females (66%), P = 0.0004. Proportionally, early-onset COPD was seen in 42% (25 of 59) of African Americans versus 14% (45 of 317) of non-Hispanic whites, P <0.0001. Other risk factors included current smoking (56 vs. 17%, P < 0.0001) and self-report of asthma (39 vs. 25%, P = 0.008). Maternal smoking (70 vs. 44%, P = 0.0001) and maternal COPD (23 vs. 12%, P=0.03) were reported more commonly in subjects with early-onset COPD. Multivariable regression analysis found association with African American race, odds ratio (OR), 7.5 (95% confidence interval [CI], 2.3-24; P = 0.0007); maternal COPD, OR, 4.7 (95% CI, 1.3-17; P=0.02); female sex, OR, 3.1 (95% CI, 1.1-8.7; P=0.03); and each pack-year of smoking, OR, 0.98 (95% CI, 0.96-1.0; P = 0.03). Conclusions: These observations support the hypothesis that severe, early-onset COPD is prevalent in females and is influenced by maternal factors. Future genetic studies should evaluate (1) gene-by-sex interactions to address sex-specific genetic contributions and (2) gene-by-race interactions.

Original languageEnglish (US)
Pages (from-to)414-420
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Volume184
Issue number4
DOIs
StatePublished - Aug 15 2011

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Keywords

  • African Americans
  • Chronic obstructive pulmonary disease
  • Female

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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