Sex-related differences in COPD in five Latin American cities: the PLATINO study

Abstract

There is evidence to suggest sex differences exists in chronic obstructive pulmonary disease (COPD) clinical expression. We investigated sex differences in health status perception, dyspnoea and physical activity, and factors that explain these differences using an epidemiological sample of subjects with and without COPD.PLATINO is a cross-sectional, population-based study. We defined COPD as post-bronchodilator forced expiratory volume in 1 s/forced vital capacity ratio ,0.70, and evaluated health status perception (Short Form (SF)-12 questionnaire) and dyspnoea (Medical Research Council scale).Among 5,314 subjects, 759 (362 females) had COPD and 4,555 (2,850 females) did not. In general, females reported more dyspnoea and physical limitation than males. 54% of females without COPD reported a dyspnoea score o2 versus 35% of males. A similar trend was observed in females with COPD (63% versus 44%). In the entire study population, female sex was a factor explaining dyspnoea (OR 1.60, 95%CI 1.40-1.84) and SF-12 physical score (OR -1.13, 95%CI -1.56--0.71). 40% of females versus 28% of males without COPD reported their general health status as fair-to-poor. Females with COPD showed a similar trend (41% versus 34%). Distribution of COPD severity was similar between sexes, but currently smoking females had more severe COPD than currently smoking males.There are important sex differences in the impact that COPD has on the perception of dyspnoea, health status and physical activity limitation.

An Estimate of the Prevalence of COPD in Africa: A Systematic Analysis

“…Our results show a signifi cant association between patient's age and COPD prevalence in a spirometrybased data set (4,(37)(38)(39), and further point out the statistically signifi cant diff erences between spirometry and non-spirometry data, among which spirometry-based estimates generally appear more homogenous and internally consistent.…”

“…Th e limited amount of published research in Africa may be due to challenges in conducting studies that would fully adhere to internationally agreed case defi nitions (40). For example, many studies now use post-bronchodilatory spirometry as a gold standard (42); whereas others state that using post-brochodilator estimates may result in a 5-50% reduction in prevalence compared to prebronchodilator values (39). It has been suggested that the low research output refl ects the poor recent availability of research funding for COPD by funding agencies, which in turn refl ects their lack of priority given to COPD (11,16).…”

Validation of a Compact Motion Sensor for the Measurement of Physical Activity in Patients with Chronic Obstructive Pulmonary Disease

“…Secondly, the subjects recruited in the present study were all males. Although Lopez Varela et al [32] reported that women with COPD showed greater physical limitations than men, Torres et al [33] reported that gender differences in skeletal muscle characteristics were not found in COPD patients. The importance of the validation study, however, is the difference between the absolute activity and the measured activity.…”

Global and regional estimates of COPD prevalence: Systematic review and meta–analysis

“…Moreover, the prevalence of COPD among men was consistently higher than in women across all world regions, settings and income categories. Some authors question the independent etiological role of gender in the development of COPD [166], given that the risk profile among men favours the development of disease. Recent reviews suggested that increased tobacco use among women in high-income countries and the higher risk of exposure to indoor air pollution (such as biomass fuels used for cooking and heating) in low-and middle income countries may contribute to reducing gender differences in COPD in future [1].…”