Samuel C Taylor1, Ashlie A Bernhisel1, Karen Curtin2, R Rand Allingham3, Robert Ritch4, Barbara M Wirostko5. 1. Department of Ophthalmology & Visual Science, University of Utah School of Medicine and John Moran Eye Center, Salt Lake City, Utah. 2. Department of Ophthalmology & Visual Science, University of Utah School of Medicine and John Moran Eye Center, Salt Lake City, Utah; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah. 3. Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina. 4. Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York. 5. Department of Ophthalmology & Visual Science, University of Utah School of Medicine and John Moran Eye Center, Salt Lake City, Utah. Electronic address: barbara.wirostko@hsc.utah.edu.
Abstract
PURPOSE: Exfoliation syndrome (XFS) is associated with genetic variants of lysyl oxidase-like 1 (LOXL1), a key enzyme in the stabilization of extracellular matrix (ECM) and elastin, and in connective tissue repair. Because patients with chronic obstructive pulmonary disease (COPD) have increased and altered elastin degradation, an association between XFS and COPD was hypothesized and analyzed. Impact of XFS on survival in patients with COPD was evaluated. DESIGN: Case-case and case-control comparison with 5:1 age- and sex-matched controls. SUBJECTS: Total of 2943 patients with XFS, 20 589 patients with COPD, and 162 patients with both disorders seen between 1996 and 2015 were identified from Utah Population Database-linked medical records. Controls were selected and matched by sex and birth year to patients in a 5:1 ratio. METHODS: Unconditional logistic regression, using International Classification of Diseases, Ninth Revision codes (365.52 and 366.11) to define XFS and an outcome of COPD (496.0), was used to calculate the odds ratio (OR) to estimate risk of COPD in patients with XFS, adjusting for age and sex. Model covariates included race, obesity, and tobacco use. MAIN OUTCOME MEASURES: Whether XFS patients have an increased risk of developing COPD; whether COPD patients have an increased risk of XFS; and, in COPD patients, whether survival differs between those with XFS and those without. RESULTS: In XFS patients, risk of a COPD diagnosis was increased compared with that of non-XFS controls (OR = 1.41; 95% confidence interval [CI], 1.17-1.70; P < 0.0004), particularly in a tobacco users subset (OR = 2.17; 95% CI, 1.15-4.09; P = 0.02). COPD patients and controls with no COPD did not differ in their risk of an XFS diagnosis. COPD patients with XFS had significantly better survival than patients with COPD and no XFS history. CONCLUSIONS: XFS patients may have an increased risk of a COPD diagnosis compared with non-XFS individuals. In COPD patients, risk of XFS was not increased compared with those with no COPD history. In COPD patients with XFS, survival is significantly improved compared with COPD patients with no XFS history. Published by Elsevier Inc.
PURPOSE:Exfoliation syndrome (XFS) is associated with genetic variants of lysyl oxidase-like 1 (LOXL1), a key enzyme in the stabilization of extracellular matrix (ECM) and elastin, and in connective tissue repair. Because patients with chronic obstructive pulmonary disease (COPD) have increased and altered elastin degradation, an association between XFS and COPD was hypothesized and analyzed. Impact of XFS on survival in patients with COPD was evaluated. DESIGN: Case-case and case-control comparison with 5:1 age- and sex-matched controls. SUBJECTS: Total of 2943 patients with XFS, 20 589 patients with COPD, and 162 patients with both disorders seen between 1996 and 2015 were identified from Utah Population Database-linked medical records. Controls were selected and matched by sex and birth year to patients in a 5:1 ratio. METHODS: Unconditional logistic regression, using International Classification of Diseases, Ninth Revision codes (365.52 and 366.11) to define XFS and an outcome of COPD (496.0), was used to calculate the odds ratio (OR) to estimate risk of COPD in patients with XFS, adjusting for age and sex. Model covariates included race, obesity, and tobacco use. MAIN OUTCOME MEASURES: Whether XFSpatients have an increased risk of developing COPD; whether COPDpatients have an increased risk of XFS; and, in COPDpatients, whether survival differs between those with XFS and those without. RESULTS: In XFSpatients, risk of a COPD diagnosis was increased compared with that of non-XFS controls (OR = 1.41; 95% confidence interval [CI], 1.17-1.70; P < 0.0004), particularly in a tobacco users subset (OR = 2.17; 95% CI, 1.15-4.09; P = 0.02). COPDpatients and controls with no COPD did not differ in their risk of an XFS diagnosis. COPDpatients with XFS had significantly better survival than patients with COPD and no XFS history. CONCLUSIONS:XFSpatients may have an increased risk of a COPD diagnosis compared with non-XFS individuals. In COPDpatients, risk of XFS was not increased compared with those with no COPD history. In COPDpatients with XFS, survival is significantly improved compared with COPDpatients with no XFS history. Published by Elsevier Inc.
Authors: Chase Paulson; Samuel C Thomas; Orlando Gonzalez; Samuel Taylor; Cole Swiston; Jennifer S Herrick; Lori McCoy; Karen Curtin; Craig J Chaya; Brian C Stagg; Barbara M Wirostko Journal: J Clin Med Date: 2022-03-24 Impact factor: 4.241