Men and women with COPD differ in many ways

The cohort study COSYCONET identified gender-specific differences in certain symptom levels of chronic obstructive pulmonary disease (COPD) and comorbidities and their relationships. Moreover, different predictors for cardiac disease could be identified.

The German COSYCONET cohort strives to investigate the trajectory of COPD with special regard to systemic factors and comorbidity. Dr Franziska Trudzinski (University Hospital Centre Heidelberg, Germany) assessed in a new analysis whether gender-specific differences, when present in symptoms of COPD, could influence the diagnosis of cardiac comorbidities [1]. Included were 2,046 individuals (38.9% women) from COSYCONET with information on clinical history, comorbidity status, and lung function. Also available were results of the 8-item COPD Assessment Test (CAT) and Medical Research Council Dyspnoea Scale (mMRC). Mean age was 65 years, BMI was 26.6 kg/m², Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifications 1–4, ratio for forced expiratory volume in 1 second/forced vital capacity ratio (FEV₁/FVC) was 51.6. Smoking status was assessed as well. Using multivariate regression, gender-associated differences in the link between symptoms, functional impairments, comorbidities, and the distinct CAT items were evaluated. Furthermore, data on cardiac disease, represented by coronary artery disease, heart failure, and myocardial infarction, was valued individually for women and men to assess for possible predictors of cardiac comorbidity.

The study discovered noteworthy differences between women and men for certain CAT items, as well as for the majority of functional parameters and comorbidities. Cough (CAT 1), phlegm (CAT 2), and activities (CAT 5) were significantly dissimilar between genders (P<0.05). For gender-specific disparities in the relationship of symptoms, functional parameters, and comorbidities, associations were apparent for energy (CAT 8) and activities (CAT 5) in men and chest tightness (CAT 3) in women. These same CAT items per gender were also associated with cardiac disease. The authors deduced that gender-specific differences in COPD not only comprised differences in levels of symptoms, comorbidities, and functional alterations but also differences in their mutual relationships. These findings suggest that diagnostic information should be used differently in men and women.

1. Trudzinski FC, et al. Gender-Specific Differences in COPD Symptoms and Their Impact for the Diagnosis of Cardiac Comorbidities: Results from COSYCONET. Session TP39: COPD Comorbidities. ATS 2021 International Conference, 14-19 May.

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Posted on 5 July 2021