Am. J. Respir. Crit. Care Med., Volume 164, Number 8, October 2001, 1419-1424

Siblings of Patients With Severe Chronic Obstructive Pulmonary Disease Have a Significant Risk of Airflow Obstruction

SEAN C. McCLOSKEY, BIPEN D. PATEL, SUSAN J. HINCHLIFFE, ELAINE D. REID, NICHOLAS J. WAREHAM, and DAVID A. LOMAS

Respiratory Medicine Unit, Department of Medicine, University of Cambridge, The Wellcome Trust Centre for Molecular Mechanisms in Disease, Cambridge Institute for Medical Research, Cambridge; and Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, Cambridge, United Kingdom

Although familial clustering has been described, few studies have quantified the risk of airflow obstruction in siblings of patients with chronic obstructive pulmonary disease (COPD). One hundred fifty-two subjects with airflow obstruction and a low gas transfer factor (but without PiZ ₁-antitrypsin deficiency) were identified and 150 were enrolled in the study. Complete data were obtained from 173 of 221 siblings of these subjects. Forty-four of 126 current or ex-smoking siblings had airflow obstruction (FEV₁/FVC < 0.7) and 36 also had a FEV₁ < 80% predicted, in keeping with COPD. One hundred eleven current or ex-smoking siblings were matched for age, sex, and smoking history with 419 subjects, without a known family history of COPD, from the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort. The prevalence of COPD was much lower in the EPIC group (9.3%) when compared with the siblings (31.5%; odds ratio, 4.70; 95% confidence interval, 2.63 to 8.41). The odds ratio for COPD in siblings with less than a 30 pack-year smoking history was 5.39 (95% confidence interval, 2.49 to 11.67) when compared with matched control subjects. Taken together these results demonstrate a significant familial risk of airflow obstruction in smoking siblings of patients with severe COPD.

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