Gender-related differences in severe, early-onset chronic obstructive pulmonary disease
Gender-related differences in severe, early-onset chronic obstructive pulmonary disease
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DOI：
10.1164/ajrccm.162.6.2003112
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发表时间：
2000-12-01
影响因子：
24.7
通讯作者：
Speizer, FE
中科院分区：
文献类型：
--
作者：
Silverman, EK;Weiss, ST;Speizer, FE
男性慢性阻塞性肺病（COPD）的患病率高于女性，这归因于男性吸烟率历来较高。然而，在过去几十年中，女性吸烟率的增加与女性COPD发病率的稳步增加有关。作为严重早发性COPD遗传学研究的一部分，我们收集了一组84名严重早发性COPD先证者（无严重α 1-抗胰蛋白酶缺乏症）及其348名一级亲属。我们发现早发COPD先证者中女性的患病率显著升高（71.4%）。在早发COPD先证者的整个一级亲属组中，单变量分析显示男性和女性的肺功能测定值和支气管扩张剂反应性相似;然而，在当前或已戒烟者中，女性一级亲属的FEV 1/ FVC显著较低（女性81.4 +/- 17.2% vs男性87.0 +/- 12.9%，p = 0.009）和显著更高的支气管扩张剂反应性（表示为基线FEV 1的百分比）（女性7.7 +/- 9.4%预测值vs男性4.1 +/- 6.4%预测值，p = 0.002）。女性吸烟的一级亲属比男性吸烟的一级亲属更有可能表现出FEV 1的显著降低（<40%pred）（p = 0.03）。采用广义估计方程进行的多变量分析表明，目前或已戒烟的女性一级亲属FEV 1 < 80%预测值的风险显著更大。（OR 1.91，95% CI 1.03-3.54），FEV 1 < 40%预测值（OR 3.56，95% CI 1.08-11.71），支气管扩张剂反应大于基线FEV 1的10%（OR 4.74，95% CI 1.91-11.75）。这些结果表明，女性可能更容易患上严重的COPD。
Men have higher prevalence rates of chronic obstructive pulmonary disease (COPD) than women, which has been attributed to the historically higher rates of cigarette smoking in males. However, the increased rates of cigarette smoking in females within the last several decades have been associated with steadily Increasing rates of COPD in women. As part of a study of the genetics of severe, early-onset COPD, we assembled a group of 84 probands with severe, early-onset COPD (without severe alpha(1)-antitrypsin deficiency) and 348 of their first-degree relatives. We found a markedly elevated prevalence (71.4%) of females among the early-onset COPD probands. Among the entire group of first-degree relatives of early-onset COPD probands, univariate analysis demonstrated similar spirometric values and bronchodilator responsiveness in males and females; however, among current or ex-smokers, female first-degree relatives had significantly lower FEV1/ FVC (81.4 +/- 17.2% in females versus 87.0 +/- 12.9% in males, p = 0.009) and significantly greater bronchodilator responsiveness (expressed as percentage of baseline FEV1) (7.7 +/- 9.4% pred in females versus 4.1 +/- 6.4% pred in males, p = 0.002). Female smoking first-degree relatives were significantly more likely to demonstrate profound reductions in FEV1 (< 40% pred) than male smoking first-degree relatives (p = 0.03). Multivariate analysis, performed with generalized estimating equations, demonstrated that current or ex-smoking female first-degree relatives had significantly greater risk of FEV1 < 80% pred (OR 1.91, 95% CI 1.03-3.54), FEV1 < 40% pred (OR 3.56, 95% CI 1.08-11.71), and bronchodilator response greater than 10% of baseline FEV1 (OR 4.74, 95% CI 1.91-11.75). These results suggest that women may be more susceptible to the development of severe COPD.