<p>Clinical Characteristics of Chronic Obstructive Pulmonary Disease in Female Patients: Findings from a KOCOSS Cohort</p>

Abstract

The prevalence of chronic obstructive pulmonary disease (COPD) in females has increased, changing the concept of COPD as a disease mostly limited to males. In this study, the clinical characteristics of COPD in females were investigated. Patients and Methods: The study was based on a multicenter cohort of COPD patients recruited from 54 medical centers in South Korea. Sex-based differences in general characteristics, exposure risk factors, depression scores, results of pulmonary function tests, COPD exacerbation, symptom scores, and radiologic findings were evaluated. Sex-related differences in the annual FEV 1 change over 5 years were analyzed in a linear mixed model. Results: Of the 2515 patients enrolled in this study, 8.1% were female. Female patients who had a higher BMI and a lower level of education were less likely to be smokers, were more exposed to passive smoking/biomass, and were more depressed compared to males. The rates of bronchiectasis, previous childhood respiratory infection, and asthma were higher in females. Female patients also had more symptoms and a poorer exercise capacity than males, but no significant differences were observed in terms of exacerbations. Radiologic findings revealed that male patients had worse emphysema, and female patients had worse bronchiectasis, as determined based on chest X-ray and computed tomography findings. On pulmonary function tests, female patients had less obstruction and less annual FEV 1 loss over 5 years. Conclusion: This study revealed differences in the clinical parameters between male and female patients with COPD, including general characteristics, disease characteristics, and clinical outcomes.

Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET

“…Increased airway hyperresponsiveness as observed in women leads to higher susceptibility to cigarette smoke, resulting in stronger lung function decline compared to men 34 . Inline with other COPD cohorts 12 , 35 , we found women to be more often diagnosed with concomitant asthma than men, and this was associated with an increased mortality risk in women but not in men. When considering the fact that for the asthma-COPD overlap syndrome the results of previous studies are not fully consistent 36 , 37 , our findings raise the possibility that this could be due to different proportions of women and men in the different studies.…”

The Human Microbiome, an Emerging Key-Player in the Sex Gap in Respiratory Diseases

“…In adulthood, a sex-based difference is also observed in COPD with regard to clinicoradiographic phenotype, symptom severity, and quality of life. Female patients are more sensitive to the adverse effects of smoking, have more symptoms such as dyspnea or cough, and have a higher proportion of bronchiectasis (3,21,22).…”

“…However, mucus hypersecretion is deleterious in multiple chronic respiratory diseases such as CF or COPD (51). Both MUC5AC and MUC5B are upregulated by estradiol (21,50). Thus, estradiol, by causing excessive mucus production, could be a detrimental factor in chronic lung infections.…”

Differences in Pulmonary and Extra-Pulmonary Traits between Women and Men with Chronic Obstructive Pulmonary Disease

“…In terms of clinical presentation, evidence suggests that women exhibit more frequently the chronic bronchitis phenotype [7], higher levels of dyspnea [8] and symptoms of anxiety and depression [9], and less exercise tolerance when compared to men [8]. However, conflicting data exist in terms of sex-related differences on health-related quality of life, number of exacerbations and hospital admissions [3,7,8,10]. Little is also known about sex-related differences in other important features such as body composition, physical activity, and fatigue.…”