Sex-specific features of emphysema among current and former smokers with COPD.
Sex-specific features of emphysema among current and former smokers with COPD.
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DOI：
10.1183/13993003.00996-2015
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发表时间：
2016-01
期刊：
影响因子：
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通讯作者：
COPDGene Investigators
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作者：
Hardin M;Foreman M;Dransfield MT;Hansel N;Han MK;Cho MH;Bhatt SP;Ramsdell J;Lynch D;Curtis JL;Silverman EK;Washko G;DeMeo D;COPDGene Investigators
最近的研究表明，患有COPD的男性比女性有更多的肺气肿。目前尚不清楚这些差异是否在COPD严重程度之间持续存在。我们的目的是根据COPD严重程度确定COPD亚组中定量肺气肿的性别特异性差异。我们纳入了来自COPD基因研究的非西班牙裔白色和非裔美国人受试者，他们至少有10包-年的吸烟史，COPD GOLD肺功能测定II级或更高。在早发COPD（<55岁）和晚期肺气肿（> 25%肺气肿）受试者中，我们通过GOLD肺量计分级检查了对数转换肺气肿（%LAA）的性别特异性差异。与女性相比，男性的log %LAA更高：总体（1.97 ± 1.4 vs 1.69±1.6，P =0.32（0.04），P=1.34×10-14），非西班牙裔白人（P=8.37×10-14）和非裔美国人受试者（P=0.002）。早发COPD、重度肺气肿和GOLD IV级COPD女性患者的肺气肿与男性相似，但吸烟包年数明显较少（早发P=0.01，重度肺气肿和GOLD IV级P<0.001）。这项研究确定了COPD女性吸烟者的亚群，她们特别容易受到实质破坏。
Recent studies suggest that men with COPD have more emphysema than women. 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 ten pack-years of smoking and COPD GOLD spirometry grade II or greater. We examined sex-specific differences in log-transformed emphysema (%LAA) by GOLD spirometry grade, among subjects with early-onset COPD (<55 years old) and advanced emphysema (>25 % emphysema). Compared to women, men had higher log %LAA: overall (1.97 ± 1.4 v 1.69±1.6, ß=0.32(0.04), P=1.34×10-14), among non-Hispanic whites (P=8.37×10-14), and African American subjects (P=0.002). Women with early-onset COPD, severe emphysema, and GOLD grade IV COPD had similar emphysema as men 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.