scholarly journals Low Alanine Aminotransferase as a Risk Factor for Chronic Obstructive Pulmonary Disease in Males: A Retrospective Population-based Cohort Study

2021 ◽  
Author(s):  
Yong Jun Choi ◽  
Do Sun Kwon ◽  
Taehee Kim ◽  
Jae Hwa Cho ◽  
Hyung Jung Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Risk Factor ◽  
Pulmonary Disease ◽  
Alanine Aminotransferase ◽  
Cox Regression ◽  
Significant Risk ◽  
Population Based ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis

Abstract Alanine aminotransferase (ALT) levels reflect skeletal muscle volume and general performance scales, which are significantly associated with chronic obstructive pulmonary disease (COPD) development and prognosis. The aim of this study was to investigate the ALT levels as a risk factor for COPD development. This 13-year population-based retrospective cohort observational study included patients registered in the health check-up cohort database of the Korean National Health Insurance Service. A total of 422,452 participants were analysed. We classified groups according to the baseline ALT levels (groups 1–5: ALT (IU/L) < 10; 10–19; 20–29; 30–39; and ≥ 40, respectively). The incidence of COPD was highest in group 1, decreasing as the group number increased among in males. Cox regression analysis in males revealed that lower ALT level was a significant risk factor for COPD development (univariable, HR: 0.992, 95% CI: 0.991–0.994; multivariable, HR: 0.998, 95% CI: 0.996–0.999). In addition, in the low ALT level groups (< 40 IU/L), COPD was more likely to be developed (univariable, HR: 1.341, 95% CI: 1.263–1.424; multivariable, HR: 1.097, 95% CI: 1.030–1.168). Our findings suggest that males with low ALT levels should be carefully monitored for COPD development.

scholarly journals Low alanine aminotransferase as a risk factor for chronic obstructive pulmonary disease in males

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Jun Choi ◽  
Do Sun Kwon ◽  
Taehee Kim ◽  
Jae Hwa Cho ◽  
Hyung Jung Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Risk Factor ◽  
Pulmonary Disease ◽  
Alanine Aminotransferase ◽  
Cox Regression ◽  
Significant Risk ◽  
Continuous Variable ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis

AbstractAlanine aminotransferase (ALT) levels reflect skeletal muscle volume and general performance, which are associated with chronic obstructive pulmonary disease (COPD) development and prognosis. This study aimed to investigate ALT levels as a risk factor for COPD development. This 13-year population-based retrospective observational cohort study included 422,452 participants for analysis. We classified groups according to the baseline ALT levels (groups 1–5: ALT (IU/L) < 10; 10–19; 20–29; 30–39; and ≥ 40, respectively). The incidence of COPD was the highest in group 1, decreasing as the group number increased in males, but not in females. The Cox regression analysis in males revealed that a lower ALT level, as a continuous variable, was a significant risk factor for COPD development [univariable, hazard ratio (HR): 0.992, 95% confidence interval (CI): 0.991–0.994; multivariable, HR: 0.998, 95% CI: 0.996–0.999]. In addition, COPD was more likely to develop in the lower ALT level groups (groups 1–4; < 40 IU/L), than in the highest ALT level group (group 5; ≥ 40 IU/L) (univariable, HR: 1.341, 95% CI: 1.263–1.424; multivariable, HR: 1.097, 95% CI: 1.030–1.168). Our findings suggest that males with low ALT levels should be carefully monitored for COPD development.

scholarly journals Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2811
Author(s):  
Corrado Pelaia ◽  
Daniele Pastori ◽  
Giuseppe Armentaro ◽  
Sofia Miceli ◽  
Velia Cassano ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Renal Function ◽  
Pulmonary Disease ◽  
Cox Regression ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cox Regression Analysis ◽  
Copd Patients ◽  
Incidence Of Ckd

Background. Chronic obstructive pulmonary disease (COPD) patients have multiple comorbidities which may affect renal function. Chronic kidney disease (CKD) is a risk factor for adverse outcomes in COPD patients. The predictors of CKD in COPD are not well investigated. Methods. A multicenter observational cohort study including patients affected by COPD (GOLD stages 1 and 2) was carried out. Principal endpoints were the incidence of CKD, as defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and the rapid decline of eGFR >5 mL/min/1.73 m2/year. Results. We enrolled 707 outpatients. Overall, 157 (22.2%) patients had CKD at baseline. Patients with CKD were older, with higher serum uric acid (UA) levels, and lower FEV1. During a mean follow-up of 52.3 ± 30.2 months, 100 patients developed CKD, and 200 patients showed a rapid reduction of eGFR. Multivariable Cox regression analysis displayed that UA (hazard ratio (HR) 1.148, p < 0.0001) and diabetes (HR 1.050, p < 0.0001) were predictors of incident CKD. The independent predictors of rapidly declining renal function were represented by an increase of 1 mg/dL in UA (odds ratio (OR) 2.158, p < 0.0001)), an increase of 10 mL/min/1.73 m2 in baseline eGFR (OR 1.054, p < 0.0001) and the presence of diabetes (OR 1.100, p < 0.009). Conclusions. This study shows that COPD patients have a significant worsening of renal function over time and that UA and diabetes were the two strongest predictors. Optimal management of these risk factors may reduce the incidence of CKD in this population thus probably improving clinical outcome.

scholarly journals Clinical features and prognostic analysis of patients with Aspergillus isolation during acute exacerbation of chronic obstructive pulmonary disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu Gu ◽  
Xianping Ye ◽  
Yu Wang ◽  
Kunlu Shen ◽  
Jinjin Zhong ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Clinical Features ◽  
Antifungal Therapy ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Positive Culture ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Abstract Background Lower respiratory tract (LRT) specimen culture is widely performed for the identification of Aspergillus. We investigated the clinical features and prognosis of patients with Aspergillus isolation from LRT specimens during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods This is a 6-year single-center, real-world study. 75 cases out of 1131 hospitalized AECOPD patients were positive for Aspergillus. These patients were carefully evaluated and finally diagnosed of pulmonary aspergillosis (PA, 60 cases, 80%) or colonization (15 cases, 20%). Comparisons of clinical data were performed between these two groups. A cox regression model was used to confirm prognostic factors of Aspergillus infection. Results The PA group had worse lung function and higher rates of systemic corticosteroid use and broad-spectrum antibiotic use before admission than the colonization group. The PA group had significantly higher in-hospital mortality and 180-day mortality than the colonization group (45% (27/60) vs. 0% (0/15), p = 0.001, and 52.5% (31/59) vs. 6.7% (1/15), p < 0.001, respectively). By multivariable analysis among Aspergillus infection patients, antifungal therapy (HR 0.383, 95% CI 0.163–0.899, p = 0.027) was associated with improved survival, whereas accumulated dose of systemic steroids > 700 mg (HR 2.452, 95% CI 1.134–5.300, p = 0.023) and respiratory failure at admission (HR 5.983, 95% CI 2.487–14.397, p < 0.001) were independently associated with increased mortality. Significant survival differential was observed among PA patients without antifungals and antifungals initiated before and after Aspergillus positive culture (p = 0.001). Conclusions Aspergillus isolation in hospitalized AECOPD patients largely indicated PA. AECOPD patients with PA had worse prognosis than those with Aspergillus colonization. Empirical antifungal therapy is warranted to improve the prognosis for Aspergillus infection.

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