Abstract
Objective: Several studies support that the risk of asthma exacerbations (AE) is higher in women than in men. We analyze whether this association can be explained by confounding due to variables such as obesity or older age.
Methods: Retrospective population-based cohort study including 2000 asthmatic adult patients obtained by simple-random-sampling. AE requiring oral corticosteroid were considered as ‘moderate’, and AE requiring ‘parenteral corticosteroid and/or magnesium sulphate’ were considered as ‘severe’. Adjusted Odds Ratios (OR) and their 95% confidence intervals (95%CI) were estimated by logistic regression.
Results: The overall mean age was 41.7 years [SD=19.7], with 46.2 % of men and 53.8 % of women. Women had a higher risk of suffering at least one moderate exacerbation the follow-up year: OR 2.01; 95%CI (1.42 to 2.85). Both obesity: OR 2.40; 95%CI (1.51 to 3.81) and age: OR (increase per decade) 1.31; 95%CI (.1.21 to 1.41) were associated with a higher risk of AE, meeting the criteria to be treated as confounding variables. After including age as a confounding variable, the association between being female and the risk of AE did not change substantially: OR 1.56; 95%CI (1.09 to 2.25). After including obesity (BMI) association also remained: OR 1.73; 95%CI (1.16 to 2.57). However, after including both obesity and age together in the same multivariable model, the association between being female and the risk of AE diminished and lost statistical significance: OR 1.44; 95% CI (0.95 to 2.17).
Conclusions: Female gender is associated with an increased risk of AE. However, this association can be explained by women’s older age and obesity, acting both as confounders.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5059.
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- Copyright ©the authors 2019