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Medical Science Monitor Basic Research


eISSN: 1643-3750

Low Serum Levels of Alpha1 Anti-trypsin (α1-AT) and Risk of Airflow Obstruction in Non-Primary α1-AT-Deficient Patients with Compensated Chronic Liver Disease

Elizabeth Rodríguez-Romero, Juan Antonio Suárez-Cuenca, César Iván Elizalde-Barrera, Paul Mondragón-Terán, José Enrique Martínez-Hernández, Eduardo Gómez-Cortés, Rebeca Pérez-Cabeza de Vaca, Rolando E. Hernández-Muñoz, Alberto Melchor-López, Nayeli Gabriela Jiménez-Saab

Department of Internal Medicine, Xoco General Hospital, and Ticomán General Hospital, Mexico City, Mexico

Med Sci Monit 2015; 21:1194-1199

DOI: 10.12659/MSM.893350

Available online:

Published: 2015-04-27


BACKGROUND: Alpha1 anti-trypsin (α1-AT), a serine protease inhibitor synthesized in the liver, is a major circulating antiprotease that provides defense against proteolytic damage in several tissues. Its deficiency is associated with airflow obstruction. The present study aimed to explore the role of α1-AT as a biomarker of airflow performance in chronic liver disease (CLD).
MATERIAL AND METHODS: Serum α1-AT levels and lung function (spirometry) were evaluated in non-primary α1-AT-deficient, alcoholic CLD patients without evident respiratory limitations.
RESULTS: Thirty-four patients with airflow obstruction (n=11), airflow restriction (n=12), and normal airflow (n=11, age-matched controls) were eligible. α1-AT was decreased in the airflow obstruction group. ROC-cutoff α1-AT=24 mg/dL effectively discriminated airflow obstruction (AUC=0.687) and was associated with a 10-fold higher risk (p=0.0007).
CONCLUSIONS: Lower α1-AT increased the risk of airflow obstruction in CLD patients without primary α1-AT deficiency.

Keywords: Adult, Biomarkers - blood, Case-Control Studies, Cross-Sectional Studies, Liver Diseases, Alcoholic - physiopathology, Lung Diseases, Obstructive - physiopathology, Pulmonary Disease, Chronic Obstructive - physiopathology, Risk Factors, Spirometry, alpha 1-Antitrypsin - blood, alpha 1-Antitrypsin Deficiency - physiopathology