title: Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort.
abstract: BACKGROUND
  Although women with severe non-allergic asthma may represent a substantial proportion of adults with asthma in clinical practice, gender differences in the incidence of allergic and non-allergic asthma have been little investigated in the general population.
  
  
  METHODS
  Gender differences in asthma prevalence, reported diagnosis and incidence were investigated in 9091 men and women randomly selected from the general population and followed up after 8-10 years as part of the European Community Respiratory Health Survey. The protocol included assessment of bronchial responsiveness, IgE specific to four common allergens and skin tests to nine allergens.
  
  
  RESULTS
  Asthma was 20% more frequent in women than in men over the age of 35 years. Possible under-diagnosis of asthma appeared to be particularly frequent among non-atopic individuals, but was as frequent in women as in men. The follow-up of subjects without asthma at baseline showed a higher incidence of asthma in women than in men (HR 1.94; 95% CI 1.40 to 2.68), which was not explained by differences in smoking, obesity or lung function. More than 60% of women and 30% of men with new-onset asthma were non-atopic. The incidence of non-allergic asthma was higher in women than in men throughout all the reproductive years (HR 3.51; 95% CI 2.21 to 5.58), whereas no gender difference was observed for the incidence of allergic asthma.
  
  
  CONCLUSIONS
  This study shows that female sex is an independent risk factor for non-allergic asthma, and stresses the need for more careful assessment of possible non-allergic asthma in clinical practice, in men and women.
authors.affiliation: INSERM Unité 700, Epidémiologie - Faculté de Médecine X, Bichat, 16 Rue Henri Huchard, Paris 75018, France. benedicte.leynaert@inserm.fr
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Leynaert
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia-Esteban
authors.forename: Cecilie
authors.initials: C
authors.lastname: Svanes
authors.forename: Deborah
authors.initials: D
authors.lastname: Jarvis
authors.forename: Isa
authors.initials: I
authors.lastname: Cerveri
authors.forename: Julia
authors.initials: J
authors.lastname: Dratva
authors.forename: Thorarinn
authors.initials: T
authors.lastname: Gislason
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
authors.forename: Nino
authors.initials: N
authors.lastname: Kuenzli
authors.forename: Roberto
authors.initials: R
authors.lastname: de Marco
authors.forename: Ernst
authors.initials: E
authors.lastname: Omenaas
authors.forename: Chantal
authors.initials: C
authors.lastname: Raherison
authors.forename: Francisco
authors.initials: F
authors.lastname: Gómez Real
authors.forename: Matthias
authors.initials: M
authors.lastname: Wjst
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Zemp
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Zureik
authors.forename: Peter G J
authors.initials: PG
authors.lastname: Burney
authors.forename: Josep M
authors.initials: JM
authors.lastname: Anto
authors.forename: Françoise
authors.initials: F
authors.lastname: Neukirch
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D001980:Bronchi / Q000276:immunology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens