Abstract
Recent studies suggest that males with chronic obstructive pulmonary disease (COPD) have more emphysema than females. It is not known if these differences persist across degrees of COPD severity. Our aim was to identify sex-specific differences in quantitative emphysema within COPD subgroups based on COPD severity.
We included non-Hispanic white and African-American subjects from the COPDGene study with at least 10 pack-years of smoking and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometry grade II or greater. We examined sex-specific differences in log-transformed emphysema (log per cent low-attenuation area (%LAA)) by GOLD spirometry grade among subjects with early-onset COPD (<55 years old) and advanced emphysema (>25% emphysema).
Compared with females, males had higher log %LAA: overall (1.97±1.4 versus 1.69±1.6, β=0.32 (0.04), p=1.34×10−14), and among non-Hispanic white (p=8.37×10−14) and African-American subjects (p=0.002). Females with early-onset COPD, severe emphysema and GOLD grade IV COPD had similar emphysema as males, but markedly fewer pack-years smoking (early-onset, p=0.01; severe emphysema and GOLD grade IV, p<0.001).
This study identifies subsets of female smokers with COPD who are particularly susceptible to parenchymal destruction.
Abstract
In severe COPD subgroups, females have greater susceptibility to smoking-related parenchymal lung damage/emphysema http://ow.ly/Stqyz
Footnotes
For editorial comments see Eur Respir J 2016; 47: 19–22 [DOI: 10.1183/13993003.01781-2015].
This article has supplementary material available from erj.ersjournals.com
Support statement: R01 HL089438, K12 HL120004, R01 HL089856, R01 HL089897, P01 HL105339, 2013 Sheila J. Goodnight, MD, FCCP Clinical Research Grant in Women's Lung Health. The COPDGene project described was supported by Award Number R01 HL089897 and Award Number R01 HL089856 from the National Heart, Lung, and Blood Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. The COPDGene project is also supported by the COPD Foundation through contributions made to an Industry Advisory Board comprised of AstraZeneca, Boehringer Ingelheim, Novartis, Pfizer, Siemens, Sunovion and GlaxoSmithKline. Funding information for this article has been deposited with FundRef.
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
- Received June 23, 2015.
- Accepted September 5, 2015.
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