Development of predictive models for airflow obstruction in alpha-1-antitrypsin deficiency

P. J. Castaldi, D. L. Demeo, D. M. Kent, E. J. Campbell, A. F. Barker, M. L. Brantly, E. Eden, N. G. McElvaney, S. I. Rennard, J. M. Stocks, J. K. Stoller, C. Strange, G. Turino, R. A. Sandhaus, J. L. Griffith, E. K. Silverman

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Alpha-1-antitrypsin deficiency is a genetic condition associated with severe, early-onset chronic obstructive pulmonary disease (COPD). However, there is significant variability in lung function impairment among persons with the protease inhibitor ZZ genotype. Early identification of persons at highest risk of developing lung disease could be beneficial in guiding monitoring and treatment decisions. Using a multicenter, family-based study sample (2002-2005) of 372 persons with the protease inhibitor ZZ genotype, the authors developed prediction models for forced expiratory volume in 1 second (FEV1) and the presence of severe COPD using demographic, clinical, and genetic variables. Half of the data sample was used for model development, and the other half was used for model validation. In the training sample, variables found to be predictive of both FEV1 and severe COPD were age, sex, pack-years of smoking, bronchodilator responsiveness, chronic bronchitis symptoms, and index case status. In the validation sample, the predictive model for FEV1 explained 50% of the variance in FEV1, and the model for severe COPD exhibited excellent discrimination (c statistic=0.88).

Original languageEnglish (US)
Pages (from-to)1005-1013
Number of pages9
JournalAmerican Journal of Epidemiology
Volume170
Issue number8
DOIs
StatePublished - Oct 2009

Keywords

  • Alpha-1-antitrypsin deficiency
  • Genetics
  • Polymorphism, single nucleotide
  • Pulmonary disease, chronic obstructive

ASJC Scopus subject areas

  • Epidemiology

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    Castaldi, P. J., Demeo, D. L., Kent, D. M., Campbell, E. J., Barker, A. F., Brantly, M. L., Eden, E., McElvaney, N. G., Rennard, S. I., Stocks, J. M., Stoller, J. K., Strange, C., Turino, G., Sandhaus, R. A., Griffith, J. L., & Silverman, E. K. (2009). Development of predictive models for airflow obstruction in alpha-1-antitrypsin deficiency. American Journal of Epidemiology, 170(8), 1005-1013. https://doi.org/10.1093/aje/kwp216