The study was led by Fernando J. Martinez, M.D., of the University of Michigan. The investigators analyzed 1053 randomized patients--38.8 percent of whom were female. Patients were selected for severe chronic airflow obstruction and an emphysematous phenotype. They then compared symptomatic, physiological, radiological and histological data between men and women.
Women in the study had shorter smoking histories and lower body mass index than men, and experienced more breathlessness, lower lung function and decreased exercise capacity compared to men. They also reported more depression, a lower quality of well-being and scored more poorly on a test for overall mental health.
Radiological assessment showed that women had less extensive emphysema than men, with smaller emphysematous lesions. Histological analysis of lung tissue in 101 patients showed that women had airways with thicker walls, and disproportionately reduced airway lumens in comparison to men.
However, even after controlling for age, FEV1 (a standard measure of lung function), smoking history and severity of emphysema, the researchers found that women reported more breathlessness, higher depression, lower mental health and lower overall quality of life than men. “These data showing greater breathlessness in women relative to men at similar degrees of airflow obstruction and emphysema severity imply that sex-specific anatomic differences must be considered in models of chronic obstructive pulmonary disease, or COPD pathogenesis,” the researchers wrote.
The fact that women in the study exhibited similarly severe COPD to men but had shorter smoking histories raises some important questions about the nature and progression of COPD with regard to sex.
MEDICA.de; Source: American Thoracic Society