Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort

Abstract

Background Although women with severe non-allergic asthma may represent a substantial proportion of adults with asthma in clinical practice, gender differences in the incidence of allergic and non-allergic asthma have been little investigated in the general population. Methods Gender differences in asthma prevalence, reported diagnosis and incidence were investigated in 9091 men and women randomly selected from the general population and followed up after 8e10 years as part of the European Community Respiratory Health Survey. The protocol included assessment of bronchial responsiveness, IgE specific to four common allergens and skin tests to nine allergens. Results Asthma was 20% more frequent in women than in men over the age of 35 years. Possible underdiagnosis of asthma appeared to be particularly frequent among non-atopic individuals, but was as frequent in women as in men. The follow-up of subjects without asthma at baseline showed a higher incidence of asthma in women than in men (HR 1.94; 95% CI 1.40 to 2.68), which was not explained by differences in smoking, obesity or lung function. More than 60% of women and 30% of men with new-onset asthma were non-atopic. The incidence of non-allergic asthma was higher in women than in men throughout all the reproductive years (HR 3.51; 95% CI 2.21 to 5.58), whereas no gender difference was observed for the incidence of allergic asthma. Conclusions This study shows that female sex is an independent risk factor for non-allergic asthma, and stresses the need for more careful assessment of possible non-allergic asthma in clinical practice, in men and women.

Natural Progression of Childhood Asthma Symptoms and Strong Influence of Sex and Puberty

“…First, despite the large variations, previous studies generally indicate that a higher male prevalence continues at least to age 16 years (some studies even indicate that a higher male prevalence continues well into adulthood) (4,8,10,12,14,17,31). However, our results show that greater severity of symptoms among boys stops at age 7 years.…”

“…Asthma is known to affect males more in childhood and females more in adulthood (1)(2)(3). Studies supporting this observation have focused on four epidemiologic aspects of the disease: (1) cross-sectional prevalence (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), (2) onset (18)(19)(20), (3) remission and relapse (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31), and (4) healthcare use (32)(33)(34)(35)(36)(37)(38)(39)(40).…”

Häufigkeit allergischer Erkrankungen in Deutschland

“…Die höhere Erkrankungshäufig-keit bei Frauen -im Gegensatz zu der bei Kindern häufigeren Erkrankung von Jungen -gilt als bekannt [27]. Auch für eine Erkrankung an Heuschnupfen findet sich insgesamt ein Überwiegen von weiblichen Betroffenen; ein Verhältnis, das sich in den deutschen Gesundheitssurveys erst seit 1998 beobachten lässt [28].…”

Serum estradiol concentration, estradiol-toprogesterone ratio and sputum IL-5 and IL-8 concentrations are increased in luteal phase of the menstrual cycle in perimenstrual asthma patients

“…Although the pathogenesis of asthma remains incompletely understood, it is now clear that it comprises several different endotypes, and hence there is an apparent shift in asthma perception that focuses on matching the therapy with the presence of specific, corresponding biomarkers. There is now an array of evidence demonstrating a female predominance in asthma prevalence by adulthood (22,23).…”