Racial and gender differences in susceptibility to tobacco smoke among patients with chronic obstructive pulmonary disease
Racial and gender differences in susceptibility to tobacco smoke among patients with chronic obstructive pulmonary disease
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DOI：
10.1016/j.rmed.2005.09.019
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发表时间：
2006-06-01
影响因子：
4.3
通讯作者：
Bailey, William C.
中科院分区：
文献类型：
--
作者：
Dransfield, Mark T.;Davis, Jennifer J.;Bailey, William C.
背景：虽然慢性阻塞性肺疾病（COPD）被认为是白人男性的疾病，但最近的数据显示女性和非裔美国人的死亡率上升更快。一些人认为这些群体更容易受到烟草烟雾的影响。我们在自己的 COPD 患者群体中研究了这个问题。方法：从 2003 年 3 月开始，我们前瞻性地开发了一个 COPD 研究数据库，以方便临床试验的招募。参与者是从诊所和付费广告中招募的，并记录他们的人口统计数据、医疗/吸烟史和肺活量数据。我们检查了 45 岁以上参与者的吸烟史和肺功能，吸烟年数 >= 20 包，FEV1/FVC（用力呼气量用力肺活量）< 0.70，种族调整后支气管扩张剂 FEV1 < 80%。主要结果是每包年吸烟的肺功能变化，或敏感性指数 (SI)，使用以下公式计算：（% 预测 FEV1-100）/包年。 结果：研究期间共有 585 名患者入组，其中 330 名符合我们的纳入标准。白种人比非洲裔美国人年龄更大（63 岁 vs. 58 岁，P = 0.0003），并且吸烟包年数更多（57 岁 vs. 43 岁，P = 0.0003）。种族或性别亚组之间的肺功能或支气管扩张剂可逆性没有差异。白种人每包年吸烟的肺功能损失少于非裔美国人（SI = -1.02% vs. -1.34%，P = 0.007），男性少于女性（SI = -0.98% vs. -1.21%，P = 0.001）。白种人男性似乎相对不受烟草烟雾影响 (SI = -0.93%)，而非洲裔美国女性似乎最容易受到烟草烟雾影响 (SI = -1.42%)。结论：慢性阻塞性肺病 (COPD) 患者对烟草烟雾的种族和性别易感性存在重要差异。非裔美国女性似乎面临最高的风险，并且可能从戒烟中受益最多。 (c) 2005 Elsevier Ltd. 保留所有权利。
Background: Although chronic obstructive pulmonary disease (COPD) has been considered a disease of Caucasian men, recent data show mortality rising faster among women and African-Americans. Some have suggested these groups are more susceptible to tobacco smoke. We examined this issue in our own population of COPD patients.Methods: Beginning in March 2003 we prospectively developed a COPD research database to facilitate recruitment for clinical trials. Enrollees are recruited from clinics and paid advertising and their demographics, medical/smoking histories, and spirometric data are recorded. We examined the smoking histories and pulmonary function of enrollees over 45, with >= 20 pack-years of smoking, FEV1/FVC (forced expiratory volume forced vital capacity) < 0.70, and a race-adjusted post-bronchoditator FEV1 < 80%. The primary outcome was the toss of lung function per pack-year smoked, or Susceptibility Index (SI), calculated using the formula: (% predicted FEV1-100)/pack-years.Results: A total of 585 patients enrolled during the study period and 330 met our inclusion criteria. Caucasians were older than African-Americans (63 vs. 58, P = 0.0003) and had more pack-years of smoking (57 vs. 43, P = 0.0003). There were no differences in lung function or bronchodilator reversibility among the racial or gender subgroups. Caucasians had less loss of lung function per pack-year smoked than African-Americans (SI = -1.02% vs. -1.34%, P = 0.007) and men less than women (SI = -0.98% vs. -1.21%, P = 0.001). Caucasian mates appeared relatively protected from tobacco smoke (SI = -0.93%), while African-American women appeared most susceptible (SI = -1.42%).Conclusions: There are important differences in racial and gender susceptibility to tobacco smoke among patients with COPD. African-American females appear to be at highest risk and may benefit most from smoking cessation. (c) 2005 Elsevier Ltd. All rights reserved.