Gender differences at presentation of idiopathic pulmonary fibrosis in Sweden
Gender differences at presentation of idiopathic pulmonary fibrosis in Sweden
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DOI：
10.1186/s12890-019-0994-4
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发表时间：
2019-11-27
影响因子：
3.1
通讯作者：
Ferrara, Giovanni
中科院分区：
文献类型：
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作者：
Kalafatis, Dimitrios;Gao, Jing;Ferrara, Giovanni
研究背景特发性肺纤维化（IPF）是一种预后不良的疾病，主要累及男性。性别间临床表现的差异对于诊断和随访都很重要。因此，在本研究中，我们在瑞典IPF患者队列中探讨了潜在的性别差异。方法我们研究了自2014年启动以来三年内纳入瑞典IPF登记研究的患者。对有关人口统计学、肺功能、6分钟步行试验（6 MWT）和生活质量（QoL）（King’s Brief Interstitial Lung Disease（K-BILD）评分）的数据进行横断面分析。结果348例患者（男性250例（72%），女性98例（28%），中位年龄72岁）在研究期间被纳入登记研究。吸烟史（N = 169（68%）对比N = 53（54%），p < 0.05），基线肺功能（用力肺活量，占预测值的百分比（FVC%）：68.9% +/- 14.4 vs. 73.0% +/- 17.7，p < 0.05;总肺活量，占预测值的百分比（TLC%）：62.2% +/- 11.8 vs. 68.6% +/-11.3%，p < 0.001）在男性和女性之间分别存在显著差异。合并症如冠状动脉疾病（OR：3.5-95% CI：1.6-7.6）和其他心血管疾病（包括房颤和心力衰竭）（OR：3.8-95% CI：1.9-7.8）也显示出性别间的显著差异。K-BILD显示生活质量较差，但未发现性别间总分存在差异（男性与女性分别为54 +/- 11 vs. 54 +/- 10，p = 0.61）。结论：本研究表明，女性IPF患者在入选时肺功能比男性更好，而男性患者的心血管合并症负担更重。然而，两组之间的生活质量和6 MWT结果没有差异。这些性别差异在IPF患者的诊断和随访中可能具有重要意义。
Background Idiopathic pulmonary fibrosis (IPF) is a disease with poor prognosis mainly affecting males. Differences in clinical presentation between genders may be important both for the diagnostic work-up and for follow-up. In the present study, we therefore explored potential gender differences at presentation in a Swedish cohort of IPF-patients. Methods We studied patients included in the Swedish IPF- registry over a three-year period from its launch in 2014. A cross-sectional analysis was performed for data concerning demographics, lung function, 6- min walking test (6MWT) and quality of life (QoL) (King's Brief Interstitial Lung Disease (K-BILD) score). Results Three hundred forty- eight patients (250 (72%) males, 98 (28%) females, median age 72 years in both genders) were included in the registry during the study period. Smoking history (N = 169 (68%) vs. N = 53 (54%), p < 0.05), baseline lung function (Forced vital capacity, % of predicted (FVC%): 68.9% +/- 14.4 vs. 73.0% +/- 17.7, p < 0.05; Total lung capacity, % of predicted (TLC%): 62.2% +/- 11.8 vs. 68.6% +/- 11.3%, p < 0.001) were significantly different at presentation between males and females, respectively. Comorbidities such as coronary artery disease (OR: 3.5-95% CI: 1.6-7.6) and other cardiovascular diseases (including atrial fibrillation and heart failure) (OR: 3.8-95% CI: 1.9-7.8) also showed significant differences between the genders. The K- BILD showed poor quality of life, but no difference was found between genders in total score (54 +/- 11 vs. 54 +/- 10, p = 0.61 in males vs. females, respectively). Conclusions This study shows that female patients with IPF have a more preserved lung function than males at inclusion, while males have a significant burden of cardiovascular comorbidities. However, QoL and results on the 6MWT did not differ between the groups. These gender differences may be of importance both at diagnosis and follow- up of patients with IPF.