ANTIPHOSPHOLIPID ANTIBODY SYNDROME AS A RISK FACTOR FOR COPD: MULTIPLICATIVE INTERACTION EFFECTS OF POSITIVE ANTIPHOSPHOLIPID ANTIBODIES WITH LOW TESTOSTERONE

Abstract

PURPOSE: In this study we investigated the association of Antiphospholipid Antibody Syndrome with Hypogonadism and COPD METHODS: A retrospective analysis of patients seen at clinics in Texas (January 2017-October 2018). We analyzed four different categories of APAs (antibodies against Cardiolipin, Beta-2-Glycoprotein-1, Phosphatidylserine and Phosphatidylserine/Prothrombin complex) and their interaction with testosterone. Logistic models were employed to determine association between risk factors (testosterone levels, APAs) and COPD. RESULTS: Almost half (45%) of patient population suffered from COPD, and 54% were females. Patients with COPD were older (68 years) compared to younger (52 years) patients without COPD. Higher level of AntiPhosphatidylserineIgA were positively associated with COPD while for AntiCardiolipin antibodies series, only IgM subtypes were negatively associated with outcome. Multivariate logistic regression analysis, after adjusting for age, gender, showed that older males are more susceptible to disease. Patients with low testosterone were 2 times more likely to develop COPD compared to those with normal levels of testosterone (2.16; 95%CI 1.56:2.98; P<0.00), while having higher levels of testosterone were 60% less susceptible to develop COPD (0.39; 95%CI 0.17-0.91; P = 0.00). Those who have low testosterone and high titer of aPSPTIgM were 12 times more likely to develop COPD compared to those with normal testosterone and normal aPSPTIgM titer. (12.3; 95%CI 1.93:78.15; P<0.00). CONCLUSIONS: The findings suggest that the presence of APAs has pathologic significance in patients with hypogonadism and COPD. CLINICAL IMPLICATIONS: Knowledge of biological interplay will help healthcare providers to utilize the available diagnostic resources and provide a personalized care for co-morbid patients.