Mogensen Ida, Hallberg Jenny, Palmberg Lena, Ekström Sandra, Georgelis Antonios, Melén Erik, Bergström Anna, Kull Inger
Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
ERJ Open Res. 2022 Jun 20;8(2). doi: 10.1183/23120541.00154-2022. eCollection 2022 Apr.
There are phenotypic differences in asthma in males and females. Differences in lung function between the sexes at the peak lung function level in young adulthood are so far not directly addressed. The aim of the present study was to assess lung function in early adulthood in males and females depending on asthma onset and remission.
Participants were included from the population-based birth cohort BAMSE and classified as having: never asthma, childhood asthma in remission, adolescent onset asthma or persistent asthma. Pre- and post-bronchodilator lung function (in Z-score) and lung clearance index (LCI) were measured at age 24 years. Lung function was compared stratified for sex between the never asthma and asthma groups univariately and in multiple linear regression analyses adjusted for maternal and paternal asthma, maternal smoking during pregnancy, secondary smoking, daily smoking, early respiratory syncytial virus infection, traffic pollution, childhood allergic sensitisation, and body mass index at age 24 years.
All asthma phenotypes were associated with a lower forced expiratory volume in 1 s (FEV)/forced vital capacity (FVC) post-bronchodilation at 24 years. This was most pronounced in males with persistent asthma compared to males with never asthma (regression coefficient: -0.503; 95% CI: -0.708- -0.298). Childhood asthma (in remission or persistent) was associated with a lower FEV. After adjustment, the associations remained significant for males. For females, the significant associations with lower FEV and FEV/FVC remained only for subjects with asthma in remission. Persistent asthma was associated with higher LCI in females.
In females, in contrast to males, the association between asthma and lower lung function was attenuated after adjustment for known risk factors.
哮喘在男性和女性中存在表型差异。迄今为止,尚未直接探讨青年成年期肺功能峰值水平上的性别差异。本研究的目的是根据哮喘的发作和缓解情况评估成年早期男性和女性的肺功能。
参与者来自基于人群的出生队列BAMSE,并被分类为:从未患哮喘、儿童期哮喘已缓解、青少年期起病哮喘或持续性哮喘。在24岁时测量支气管扩张前后的肺功能(以Z评分表示)和肺清除指数(LCI)。对从未患哮喘组和哮喘组的肺功能按性别进行分层比较,单因素分析以及在对父母哮喘、孕期母亲吸烟、二手烟、每日吸烟、早期呼吸道合胞病毒感染、交通污染、儿童期过敏致敏和24岁时的体重指数进行校正的多元线性回归分析中进行比较。
所有哮喘表型均与24岁时支气管扩张后1秒用力呼气容积(FEV)/用力肺活量(FVC)降低有关。与从未患哮喘的男性相比,持续性哮喘男性的这种情况最为明显(回归系数:-0.503;95%置信区间:-0.708--0.298)。儿童期哮喘(已缓解或持续性)与较低的FEV有关。校正后,男性的这些关联仍然显著。对于女性,仅在哮喘已缓解的受试者中,FEV和FEV/FVC降低的显著关联仍然存在。持续性哮喘与女性较高的LCI有关。
与男性不同,在女性中,校正已知危险因素后,哮喘与较低肺功能之间的关联减弱。