Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry
Abstract Background This study aims to evaluate the clinical characteristics of COPD patients with AATD according to their age at diagnosis. Methods Data was obtained from the European Alpha-1 Research Collaboration (EARCO) registry, an international prospective cohort study. AATD patients with COPD...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12890-025-03782-y |
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| author | Dilek Karadoğan María Torres-Duran Hanan Tanash Carlota Rodríguez-García Jens-Ulrik Stæhr Jensen Angelo Guido Corsico José Luis López-Campos Kenneth Chapman Christian Clarenbach Catarina Guimaraes Eva Bartošovská Maria Sucena Juan Luis Rodríguez-Hermosa José María Hernández-Pérez Tahsin Gökhan Telatar Yelda Varol İpek Özmen Seda Tural Alice M Turner Paul Ellis for the EARCO study group |
| author_facet | Dilek Karadoğan María Torres-Duran Hanan Tanash Carlota Rodríguez-García Jens-Ulrik Stæhr Jensen Angelo Guido Corsico José Luis López-Campos Kenneth Chapman Christian Clarenbach Catarina Guimaraes Eva Bartošovská Maria Sucena Juan Luis Rodríguez-Hermosa José María Hernández-Pérez Tahsin Gökhan Telatar Yelda Varol İpek Özmen Seda Tural Alice M Turner Paul Ellis for the EARCO study group |
| author_sort | Dilek Karadoğan |
| collection | DOAJ |
| description | Abstract Background This study aims to evaluate the clinical characteristics of COPD patients with AATD according to their age at diagnosis. Methods Data was obtained from the European Alpha-1 Research Collaboration (EARCO) registry, an international prospective cohort study. AATD patients with COPD registered between February 2020 and October 2024 were analysed. Clinical charateristics were compared between groups, stratified by age of AATD diagnosis as follows; <45, 45–65 and ≥65 years. A multivariable logistic regression model explored factors associated with age at diagnosis. Results A total of 1,565 AATD-COPD patients were included, with 18.2% receiving an AATD diagnosis at age ≥ 65. In univariate comparisons according to diagnosis age revealed that the prevalence of patients with Pi*ZZ mutation was lower in the ≥ 65 age group (47.1%) compared to the 45–65 (65.5%) and < 45 (78.5%) age groups. In contrast, the prevalence of Pi*SZ and Pi*SS were higher in the ≥ 65 group compared to the younger age groups. The proportion of never-smokers was highest in the ≥ 65 group (39.5%), whereas only 15.3% of patients under 45 were never-smokers. Multivariate analysis showed that; compared to never-smokers, former smoking (OR: 0.08; 95% CI: 0.03–0.23) and current smoking (OR: 0.43; 95% CI: 0.27–0.70) were negatively associated with a diagnosis at age ≥ 65 in all sample. Compared to the Pi*ZZ genotype, among all sample, Pi*SS was associated with more than a 3-fold increased likelihood of diagnosis at age ≥ 65 and when considering only index cases Pi*SZ was associated with diagnosis age of ≥ 65 (OR: 2.01, 95%CI: 1.01–4.04). Among patients with the Pi*ZZ, current smoking was negatively associated (OR:0.24,95%CI: 0.13–0.47) with a diagnosis at age ≥ 65, whereas higher FEV1% and serum AAT levels were positively associated with later diagnosis. Conclusion Patients diagnosed at an older age had lower tobacco exposure and less severe disease. This suggests that subclinical symptoms may contribute to delays in diagnosis, as COPD features can be subtle or under-recognised until later in life. Our findings highlight the importance of considering AATD in all COPD patients, regardless of age, to avoid missed or delayed diagnoses. |
| format | Article |
| id | doaj-art-b0a7680a1a0b4c36bcb0d66f4c9c888f |
| institution | DOAJ |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-b0a7680a1a0b4c36bcb0d66f4c9c888f2025-08-20T03:03:23ZengBMCBMC Pulmonary Medicine1471-24662025-07-0125111210.1186/s12890-025-03782-yClinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registryDilek Karadoğan0María Torres-Duran1Hanan Tanash2Carlota Rodríguez-García3Jens-Ulrik Stæhr Jensen4Angelo Guido Corsico5José Luis López-Campos6Kenneth Chapman7Christian Clarenbach8Catarina Guimaraes9Eva Bartošovská10Maria Sucena11Juan Luis Rodríguez-Hermosa12José María Hernández-Pérez13Tahsin Gökhan Telatar14Yelda Varol15İpek Özmen16Seda Tural17Alice M Turner18Paul Ellis19for the EARCO study groupDepartment of Chest Diseases, Faculty of Medicine, Recep Tayyip Erdoğan UniversityServicio de Neumología, Hospital Álvaro Cunqueiro. NeumoVigo I+i Research Group, IIS Galicia SurDepartment of Respiratory Medicine and Allergology, Skåne University Hospital, Lund UniversityServicio de Neumología, Complejo Hospitalario Clínico-Universitario de SantiagoSection of Respiratory Medicine, Department of Medicine, Herlev and Gentofte Hospital, University of CopenhagenDepartment of Internal Medicine and Medical Therapeutics, University of PaviaCentro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos IIIAsthma and Airway Centre, Division of Respiratory Medicine, Department of Medicine, University Health Network, Toronto Western Hospital, University of TorontoDivision of Pulmonology, University Hospital ZurichPulmonology Department, Hospital da Senhora da Oliveira, Unidade Local de Saúde Alto AveDepartment of Pneumology, First Faculty of Medicine, Thomayer Hospital, Charles UniversityPulmonology Department, Centro Hospitalar Universitário de Santo AntónioPulmonology Department, Department of Medicine, School of Medicine, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC)Pulmonology Department, Nuestra Señora de Candelaria University HospitalDepartment of Public Health, Faculty of Medicine, Recep Tayyip Erdoğan UniversityDepartment of Chest Diseases, İzmir Faculty of Medicine, Dr. Suat Seren Chest Diseases and Surgery Education and Training Hospital, University of Health SciencesDepartment of Chest Diseases, Hamidiye Faculty of Medicine, Süreyyapaşa Chest Diseases and Surgery Education and Training Hospital, University of Health SciencesDepartment of Chest Diseases, Hamidiye Faculty of Medicine, Yedikule Chest Diseases and Surgery Education and Training Hospital, University of Health SciencesSchool of Health Sciences, University of BirminghamSchool of Health Sciences, University of BirminghamAbstract Background This study aims to evaluate the clinical characteristics of COPD patients with AATD according to their age at diagnosis. Methods Data was obtained from the European Alpha-1 Research Collaboration (EARCO) registry, an international prospective cohort study. AATD patients with COPD registered between February 2020 and October 2024 were analysed. Clinical charateristics were compared between groups, stratified by age of AATD diagnosis as follows; <45, 45–65 and ≥65 years. A multivariable logistic regression model explored factors associated with age at diagnosis. Results A total of 1,565 AATD-COPD patients were included, with 18.2% receiving an AATD diagnosis at age ≥ 65. In univariate comparisons according to diagnosis age revealed that the prevalence of patients with Pi*ZZ mutation was lower in the ≥ 65 age group (47.1%) compared to the 45–65 (65.5%) and < 45 (78.5%) age groups. In contrast, the prevalence of Pi*SZ and Pi*SS were higher in the ≥ 65 group compared to the younger age groups. The proportion of never-smokers was highest in the ≥ 65 group (39.5%), whereas only 15.3% of patients under 45 were never-smokers. Multivariate analysis showed that; compared to never-smokers, former smoking (OR: 0.08; 95% CI: 0.03–0.23) and current smoking (OR: 0.43; 95% CI: 0.27–0.70) were negatively associated with a diagnosis at age ≥ 65 in all sample. Compared to the Pi*ZZ genotype, among all sample, Pi*SS was associated with more than a 3-fold increased likelihood of diagnosis at age ≥ 65 and when considering only index cases Pi*SZ was associated with diagnosis age of ≥ 65 (OR: 2.01, 95%CI: 1.01–4.04). Among patients with the Pi*ZZ, current smoking was negatively associated (OR:0.24,95%CI: 0.13–0.47) with a diagnosis at age ≥ 65, whereas higher FEV1% and serum AAT levels were positively associated with later diagnosis. Conclusion Patients diagnosed at an older age had lower tobacco exposure and less severe disease. This suggests that subclinical symptoms may contribute to delays in diagnosis, as COPD features can be subtle or under-recognised until later in life. Our findings highlight the importance of considering AATD in all COPD patients, regardless of age, to avoid missed or delayed diagnoses.https://doi.org/10.1186/s12890-025-03782-yAATDCOPDElderlyDiagnosis age |
| spellingShingle | Dilek Karadoğan María Torres-Duran Hanan Tanash Carlota Rodríguez-García Jens-Ulrik Stæhr Jensen Angelo Guido Corsico José Luis López-Campos Kenneth Chapman Christian Clarenbach Catarina Guimaraes Eva Bartošovská Maria Sucena Juan Luis Rodríguez-Hermosa José María Hernández-Pérez Tahsin Gökhan Telatar Yelda Varol İpek Özmen Seda Tural Alice M Turner Paul Ellis for the EARCO study group Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry BMC Pulmonary Medicine AATD COPD Elderly Diagnosis age |
| title | Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry |
| title_full | Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry |
| title_fullStr | Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry |
| title_full_unstemmed | Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry |
| title_short | Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry |
| title_sort | clinical characteristics of aatd related copd patients vary with age at diagnosis data from the earco international registry |
| topic | AATD COPD Elderly Diagnosis age |
| url | https://doi.org/10.1186/s12890-025-03782-y |
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