Author(s):
N. N.
Hansel, G. R.
Washko, M. G.
Foreman, M. K.
Han, E. A.
Hoffman, D. L.
Demeo, R. G.
Barr, E. J. R.
Van Beek, E. A.
Kazerooni, R. A.
Wise, R. H.
Brown, J.
Black-Shinn, J. E.
Hokanson, N. A.
Hanania, B.
Make, E. K.
Silverman, J. D.
Crapo, M. T.
Dransfield,
COPDGene Investigators
Abstract:
Background: Whether African Americans (AA) are more susceptible to COPD than non-Hispanic Whites (NHW) and whether racial differences in disease phenotype exist is controversial. The objective is to determine racial differences in the extent of emphysema and airway remodeling in COPD. Methods: First, 2,500 subjects enrolled in the COPDGene study were used to evaluate racial differences in quantitative CT (QCT) parameters of % emphysema, air trapping and airway wall thickness. Independent variables studied included race, age, gender, education, BMI, pack-years, smoking status, age at smoking initiation, asthma, previous work in dusty job, CT scanner and center of recruitment. Results: Of the 1,063 subjects with GOLD Stage II-IV COPD, 200 self-reported as AA. AAs had a lower mean % emphysema (13.1 % vs. 16.1%, p = 0.005) than NHW and proportionately less emphysema in the lower lung zones. After adjustment for covariates, there was no statistical difference by race in air trapping or airway wall thickness. Measured QCT parameters were more predictive of poor functional status in NHWs compared to AAs. Conclusions: AAs have less emphysema than NHWs but the same degree of airway disease. Additional factors not easily assessed by current QCT techniques may account for the poor functional status in AAs.
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ISBN:
1541-2555
Publication Year:
2013
Periodical:
Copd-Journal of Chronic Obstructive Pulmonary Disease
Periodical Number:
1
Volume:
10
Pages:
20-27
Author Address:
Hansel, NN
Johns Hopkins Asthma & Allergy Ctr, 5501 Hopkins Bayview Circle, Baltimore, MD 21224 USA
Johns Hopkins Univ, Baltimore, MD USA
Brigham & Womens Hosp, Channing Lab, Boston, MA 02115 USA
Harvard Univ, Sch Med, Boston, MA USA
Morehouse Sch Med, Atlanta, GA 30310 USA
Univ Michigan Hlth Syst, Ann Arbor, MI USA
Univ Iowa, Iowa City, IA USA
Columbia Univ, New York, NY USA
Univ Edinburgh, Edinburgh, Midlothian, Scotland
Univ Colorado, Denver, CO 80202 USA
Baylor Coll Med, Houston, TX 77030 USA
Natl Jewish Hlth, Denver, CO USA
Univ Alabama, Birmingham, CO USA