Sex differences in large conducting airway anatomy
Sex differences in large conducting airway anatomy
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DOI：
10.1152/japplphysiol.00440.2018
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发表时间：
2018-09-01
影响因子：
3.3
通讯作者：
Joyner, Michael J.
中科院分区：
文献类型：
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作者：
Dominelli, Paolo B.;Ripoll, Juan G.;Joyner, Michael J.
气道管腔面积是气管支气管树中气流阻力的主要决定因素。女性的中央传导气道可能比男性小;然而，先前的证据被气道几何形状的间接评估和既往吸烟史的受试者混淆。本研究的目的是检查性别对健康非吸烟者气道大小的影响。使用低剂量高分辨率计算机断层扫描，我们回顾性评估了不同年龄（19-86岁）的健康男性（n = 51）和女性（n = 73）的气道管腔面积。排除有吸烟史、心肺疾病或体重指数> 40 kg/m2的受试者。在三个离散点分析气管、右和左主支气管、支气管中间、左和右上叶以及左下叶的管腔面积。女性的传导气道的管腔面积类似于小26%-35%。男性和女性之间气管的管腔面积差异最大（男性和女性分别为298 +/- 47 vs. 195 +/- 28 mm（2）或小35%），而左下叶的差异最小（男性和女性分别为57 +/- 15 vs. 42 +/- 9 mm（2）或小26%）。当一部分受试者的身高相匹配时，气道管腔面积的性别差异仍然存在，女性比男性小20%-30%。所有受试者的身高与气道管腔面积之间存在中度相关性（r = 0.73-0.53，P < 0.05）。虽然有相当大的性别之间的重叠，大的传导气道的管腔面积较小，在健康的女性比男性。新的和值得注意的是以前的证据在气道大小的性别差异已混淆的间接措施和/或队列有显着的吸烟史或病理。我们发现，健康女性的中央气道明显小于男性（相似于26%-35%）。气道大小的显著性别差异减弱（小20%-30%），但在身高匹配的受试者亚组中保持不变。在不同年龄段，健康女性的中央气道比男性小。
Airway luminal area is the major determinant of resistance to airflow in the tracheobronchial tree. Women may have smaller central conducting airways than men; however, previous evidence is confounded by an indirect assessment of airway geometry and by subjects with prior smoking history. The purpose of this study was to examine the effect of sex on airway size in healthy nonsmokers. Using low-dose high-resolution computed tomography, we retrospectively assessed airway luminal area in healthy men (n = 51) and women (n = 73) of varying ages (19-86 yr). Subjects with a positive smoking history, cardiopulmonary disease, or a body mass index > 40 kg/m(2) were excluded. Luminal areas of the trachea, right and left main bronchus, bronchus intermediate, left and right upper lobes, and the left lower lobe were analyzed at three discrete points. The luminal areas of the conducting airways were similar to 26%-35% smaller in women. The trachea had the largest differences in luminal area between men and women (298 +/- 47 vs. 195 +/- 28 mm(2) or 35% smaller for men and women, respectively), whereas the left lower lobe had the smallest differences (57 +/- 15 vs. 42 +/- 9 mm(2) or 26% smaller for men and women, respectively). When a subset of subjects was matched for height, the sex differences in airway luminal area persisted, with women being similar to 20%-30% smaller. With all subjects, there were modest relationships between height and airway luminal area (r = 0.73-0.53, P < 0.05). Although there was considerable overlap between sexes, the luminal areas of the large conducting airways were smaller in healthy women than in men.NEW & NOTEWORTHY Previous evidence for sex differences in airway size has been confounded by indirect measures and/or cohorts with significant smoking histories or pathologies. We found that central airways in healthy women were significantly smaller (similar to 26%-35%) than men. The significant sex-difference in airway size was attenuated (20%-30% smaller) but preserved in a subset of subjects matched for height. Over a range of ages, healthy women have smaller central airways than men.