SESSION TYPE: COPD Posters I
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: To supplement sparse previous data by identifying predictors of chronic obstructive lung disease (COPD) subtypes.
METHODS: Cohort study of 126,019 persons who supplied baseline data from 1978 - 1985 and were followed through 2008 with analyses of hospitalizations attributed to COPD among persons with no admissions for asthma. Cox proportional hazards models with 8 covariates yielded hazard ratios (HR) 95% confidence intervals (CI), and p values. We present data for the 3 most numerous COPD subtypes: chronic bronchitis, (CB, n = 430), emphysema (E, n = 86), and chronic airway obstruction (CAO, n = 225).
RESULTS: As expected, cigarette smoking, increasing age, and history of respiratory disease/symptoms were powerful predictors (p<0.001) of all 3 types. Asian Americans (vs. whites) and college graduates (vs. no college) were at modestly lower risk of all 3 types. Males were at significantly higher risk of E, with HR (CI) of 2.1 (1.3-3.4, p=0.002), but not of CB (HR=1.2 [0.9-1.4] or CAO (HR=0.9 [0.7-1.2]). Persons with a BMI of ≥30 kg/m2 (vs <25) had a strong inverse relation to E (HR=0.2 [0.1-0.6, p=0.005) but not to CB (HR=1.2 [0.9-1.6]) or CAO (H 0.9 [0.6-1.3]). Alcohol drinking had a significant inverse relation to E but not to CB or CAO; e.g. for persons reporting 1-2 drinks per day (vs. lifelong abstainers) HR's were 0.5 (0.2-0.9, p=0.02) for E, 0.8 (0.6-1.04) for CB and 0.9 (0.6-1.3) for CAO. These disparities were generally similar in men and women
CONCLUSIONS: There are noteworthy unexplained disparities in risk factors for COPD subtypes.
CLINICAL IMPLICATIONS: These disparities presumably reflect biological differences in COPD subtype susceptibility. Further study should lead to better understanding of pathophysiology and to targeting of therapy
DISCLOSURE: The following authors have nothing to disclose: Stanton Siu, Hein Nicole Tran, Natalia Udaltsova, Arthur Klatsky
No Product/Research Disclosure InformationKaiser Permanente Medical Group, Oakland, CA