Sex-related differences in pulmonary physiologic outcome measures in a high-risk birth cohort - 06/08/15
, Michael D. Evans, MS b, Victoria Rajamanickam, MS b, Ronald E. Gangnon, PhD b, Sean B. Fain, PhD c, d, Ronald L. Sorkness, PhD a, e, f, Adesua Y. Okupa, MD a, Alex Thomas, MD a, James E. Gern, MD a, e, Robert F. Lemanske, MD a, eAbstract |
Background |
Sex influences the risk of wheezing illnesses and the prevalence of asthma throughout childhood.
Objective |
To better understand the mechanisms of these effects, we analyzed longitudinal relationships between sex, lung physiology, and asthma in the Childhood Origins of ASThma birth cohort study.
Methods |
Childhood Origins of ASThma birth cohort study children were followed prospectively from birth and assessed annually. Results of spirometry, fractional exhaled nitric oxide (Feno), mannitol provocation testing, and 3He gas magnetic resonance imaging were assessed by sex using multivariate models including age, asthma diagnosis, and wheezing histories.
Results |
Girls had higher prebronchodilator forced expiratory volume in 0.5 seconds/forced vital capacity values than did boys (mean difference, 0.017; 95% CI, 0.000-0.034; P = .05) of equivalent age. Postbronchodilator findings were more pronounced, with boys demonstrating reduced forced expiratory volume in 0.5 seconds/forced vital capacity values than did girls of equivalent age (mean difference, 0.032; 95% CI, 0.014-0.049; P = .0005). Conversely, girls were noted to have higher ventilation defects on 3He magnetic resonance imaging than did boys (P = .01). No differences were noted in the rate of positive responses to mannitol provocation or Feno measurements.
Conclusions |
Lower airflow values are present by spirometry for prepubertal boys than for age-matched girls; however, greater 3He ventilation defects were noted in girls. This could represent a greater degree of subclinical air trapping in prepubertal girls because residual volumes are not detected on standard spirometric readings. No differences were noted between the 2 sexes with airway hyperresponsiveness (mannitol provocation testing) or inflammation (Feno). Prospective peripubertal follow-up will determine whether these differences persist or change with the de novo expression and remission of asthma based on sex and age.
Le texte complet de cet article est disponible en PDF.Key words : Sex, gender, asthma, pulmonary physiology, spirometry, helium MRI, ventilation defects, mannitol, airway hyperreactivity, fractional exhaled nitric oxide
Abbreviations used : COAST, Feno, FEV0.5, FVC, MRI
Plan
| This study was supported by the National Institutes of Health (NIH) (grant no. P01 HL70831) and by the Clinical and Translational Science Award program through the NIH National Center for Advancing Translational Sciences (grant no. UL1TR000427). |
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| Disclosure of potential conflict of interest: D. J. Jackson has received research support from the National Heart, Lung, and Blood Institute (NHLBI) and has received consultancy fees from GlaxoSmithKline and Genentech. S. B. Fain has received research support from GE Healthcare. J. E. Gern has received research support from the National Institutes of Health, GlaxoSmithKline, and Merck and has received consultancy fees from GlaxoSmithKline, Johnson & Johnson, Merck, MedImmune, Boehringer Ingelheim, and Gilead. R. F. Lemanske, Jr reports grants from the University of Wisconsin, the NHLBI, and Pharmaxis and personal fees from the University of Wisconsin, Merck, Sepracor, SA Boney and Associates, GlaxoSmithKline, the American Institute of Research, Genentech, Double Helix Development, Boehringer Ingelheim, Michigan Public Health, Allegheny General Hospital, American Academy of Pediatrics, West Allegheny Health, California Chapter 4, the Colorado Allergy Society, the Pennsylvania Allergy Society, Howard Pilgrim Health, the California Society of Allergy, the NYC Allergy Society, the World Allergy Organization, Asia Pacific Association of Pediatric Allergy, Respirology and Immunology, the Western Society of Allergy, Asthma, and Immunology, the American Academy of Allergy, Asthma & Immunology, Elsevier, UpToDate, the Kuwait Allergy Society, Lurie Children's Hospital, Boston Children's Hospital, Health Star Communications, LA Children's Hospital, and Northwestern University. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 136 - N° 2
P. 282-287 - août 2015 Retour au numéro
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