title: Chronic obstructive pulmonary disease: Does gender really matter?
abstract: BACKGROUND
  Limited data is available on the clinical expression of chronic obstructive pulmonary disease (COPD) from India. The impact of gender on expression of COPD has received even less attention. Apart from tobacco smoke, indoor air pollution, especially from biomass fuel may play an important role in development of COPD in women.
  
  
  METHODS
  Seven hundred and two patients of COPD were studied regarding the etiological and risk factors leading to COPD, gender-related differences in clinical presentation, radiological expression of COPD and the co-morbidities in COPD.
  
  
  RESULTS
  Tobacco smoke in the form of beedi smoking was the predominant smoke exposure in males, whereas smoke from biofuel burning was the predominant exposure in females. As compared to males, females were younger, reported more dyspnea, more severe bronchial obstruction, more exacerbations, and exhibited higher prevalence of systemic features. Also, females smoked less and had lesser incidence of productive cough, lower body mass index, lesser co-morbidities and less number of hospital admissions as compared to males. Males were more likely than females to have an emphysema-predominant phenotype, while airway-predominant disease was more common among females.
  
  
  CONCLUSIONS
  The current study shows that gender-related differences do exist in COPD patients. Understanding these differences in etiological agent and clinical picture will help early diagnosis of COPD in females.
authors.affiliation: Department of Chest Diseases and Tuberculosis, S.M.S. Medical College, Jaipur, India.
authors.forename: N K
authors.initials: NK
authors.lastname: Jain
authors.forename: M S
authors.initials: MS
authors.lastname: Thakkar
authors.forename: N
authors.initials: N
authors.lastname: Jain
authors.forename: K A
authors.initials: KA
authors.lastname: Rohan
authors.forename: M
authors.initials: M
authors.lastname: Sharma
references.citation: COPD. 2009 Aug;6(4):256-62
references.pmid: 19811384
references.citation: Environ Res. 2005 Sep;99(1):93-8
references.pmid: 16053933
references.citation: Am J Respir Crit Care Med. 2007 Aug 1;176(3):243-52
references.pmid: 17431226
references.citation: Thorax. 1999 Dec;54(12):1119-38
references.pmid: 10567633
references.citation: Am J Respir Crit Care Med. 2006 Feb 15;173(4):393-7
references.pmid: 16322646
references.citation: J Clin Epidemiol. 2001 Mar;54(3):287-93
references.pmid: 11223326
references.citation: Curr Opin Pulm Med. 2004 Mar;10(2):98-103
references.pmid: 15021178
references.citation: Respir Res. 2005 Oct 31;6:127
references.pmid: 16255784
references.citation: Am J Respir Crit Care Med. 1996 Sep;154(3 Pt 1):701-6
references.pmid: 8810608
references.citation: Thorax. 1999 Nov;54(11):1004-8
references.pmid: 10525559
references.citation: Eur Respir J. 1997 Apr;10(4):822-7
references.pmid: 9150319
references.citation: BMC Pulm Med. 2006 Dec 19;6:27
references.pmid: 17177991
references.citation: Chest. 2001 Jun;119(6):1691-5
references.pmid: 11399692
references.citation: Indian J Chest Dis Allied Sci. 2006 Jan-Mar;48(1):23-9
references.pmid: 16482948
references.citation: Respirology. 2003 Jun;8(2):123-30
references.pmid: 12753525
references.citation: Respirology. 2004 Aug;9(3):331-6
references.pmid: 15363004
references.citation: Eur Respir J. 2007 Dec;30(6):1180-5
references.pmid: 17804445
references.citation: Int J Tuberc Lung Dis. 2008 Aug;12(8):972-7
references.pmid: 18647460
references.citation: Proc Am Thorac Soc. 2007 Dec;4(8):671-4
references.pmid: 18073400
references.citation: Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55
references.pmid: 17507545
references.citation: Clin Invest Med. 2003 Oct;26(5):243-8
references.pmid: 14596485
references.citation: PLoS Med. 2006 Nov;3(11):e442
references.pmid: 17132052
references.citation: Am J Respir Crit Care Med. 2000 Dec;162(6):2152-8
references.pmid: 11112130
references.citation: Chest. 2010 Jul;138(1):20-31
references.pmid: 20139228
references.citation: Chest. 2010 Mar;137(3):593-600
references.pmid: 19820078
references.citation: Eur Radiol. 2003 Oct;13(10):2372-7
references.pmid: 12783176
references.citation: Eur Respir J. 2006 Mar;27(3):542-6
references.pmid: 16507854
references.citation: Chest. 2007 Aug;132(2):464-70
references.pmid: 17573503
references.citation: Indian J Physiol Pharmacol. 2008 Apr-Jun;52(2):193-6
references.pmid: 19130865