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Serum IgG Levels and Risk of COPD Hospitalization: A Pooled Meta-analysis.
- Source :
-
Chest [Chest] 2020 Oct; Vol. 158 (4), pp. 1420-1430. Date of Electronic Publication: 2020 May 19. - Publication Year :
- 2020
-
Abstract
- Background: Hypogammaglobulinemia (serum IgG levels < 7.0 g/L) has been associated with increased risk of COPD exacerbations but has not yet been shown to predict hospitalizations.<br />Research Question: To determine the relationship between hypogammaglobulinemia and the risk of hospitalization in patients with COPD.<br />Study Design and Methods: Serum IgG levels were measured on baseline samples from four COPD cohorts (n = 2,259): Azithromycin for Prevention of AECOPD (MACRO, n = 976); Simvastatin in the Prevention of AECOPD (STATCOPE, n = 653), Long-Term Oxygen Treatment Trial (LOTT, n = 354), and COPD Activity: Serotonin Transporter, Cytokines and Depression (CASCADE, n = 276). IgG levels were determined by immunonephelometry (MACRO; STATCOPE) or mass spectrometry (LOTT; CASCADE). The effect of hypogammaglobulinemia on COPD hospitalization risk was evaluated using cumulative incidence functions for this outcome and deaths (competing risk). Fine-Gray models were performed to obtain adjusted subdistribution hazard ratios (SHR) related to IgG levels for each study and then combined using a meta-analysis. Rates of COPD hospitalizations per person-year were compared according to IgG status.<br />Results: The overall frequency of hypogammaglobulinemia was 28.4%. Higher incidence estimates of COPD hospitalizations were observed among participants with low IgG levels compared with those with normal levels (Gray's test, P < .001); pooled SHR (meta-analysis) was 1.29 (95% CI, 1.06-1.56, P = .01). Among patients with prior COPD admissions (n = 757), the pooled SHR increased to 1.58 (95% CI, 1.20-2.07, P < .01). The risk of COPD admissions, however, was similar between IgG groups in patients with no prior hospitalizations: pooled SHR = 1.15 (95% CI, 0.86-1.52, P =.34). The hypogammaglobulinemia group also showed significantly higher rates of COPD hospitalizations per person-year: 0.48 ± 2.01 vs 0.29 ± 0.83, P < .001.<br />Interpretation: Hypogammaglobulinemia is associated with a higher risk of COPD hospital admissions.<br /> (Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Agammaglobulinemia complications
Aged
Female
Humans
Incidence
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive complications
Pulmonary Disease, Chronic Obstructive epidemiology
Risk Assessment
Agammaglobulinemia blood
Hospitalization statistics & numerical data
Immunoglobulin G blood
Pulmonary Disease, Chronic Obstructive blood
Subjects
Details
- Language :
- English
- ISSN :
- 1931-3543
- Volume :
- 158
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Chest
- Publication Type :
- Academic Journal
- Accession number :
- 32439504
- Full Text :
- https://doi.org/10.1016/j.chest.2020.04.058