title: Sex-specific features of emphysema among current and former smokers with COPD.
abstract: Recent studies suggest that males with chronic obstructive pulmonary disease (COPD) have more emphysema than females. It is not known if these differences persist across degrees of COPD severity. Our aim was to identify sex-specific differences in quantitative emphysema within COPD subgroups based on COPD severity.We included non-Hispanic white and African-American subjects from the COPDGene study with at least 10 pack-years of smoking and COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometry grade II or greater. We examined sex-specific differences in log-transformed emphysema (log per cent low-attenuation area (%LAA)) by GOLD spirometry grade among subjects with early-onset COPD (<55 years old) and advanced emphysema (>25% emphysema).Compared with females, males had higher log %LAA: overall (1.97±1.4 versus 1.69±1.6, β=0.32 (0.04), p=1.34×10(-14)), and among non-Hispanic white (p=8.37×10(-14)) and African-American subjects (p=0.002). Females with early-onset COPD, severe emphysema and GOLD grade IV COPD had similar emphysema as males, but markedly fewer pack-years smoking (early-onset, p=0.01; severe emphysema and GOLD grade IV, p<0.001).This study identifies subsets of female smokers with COPD who are particularly susceptible to parenchymal destruction.
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA remeh@channing.harvard.edu.
authors.forename: Megan
authors.initials: M
authors.lastname: Hardin
authors.affiliation: Morehouse School of Medicine, Department of Internal Medicine, Atlanta, GA, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Foreman
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Dransfield
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Hansel
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: MeiLan K
authors.initials: MK
authors.lastname: Han
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Cho
authors.affiliation: University of Alabama, Birmingham, AL, USA.
authors.forename: Surya P
authors.initials: SP
authors.lastname: Bhatt
authors.affiliation: Division of Internal Medicine, University of California, San Diego, CA, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Ramsdell
authors.affiliation: Dept of Radiology, National Jewish Health, Denver, CO, USA.
authors.forename: David
authors.initials: D
authors.lastname: Lynch
authors.affiliation: University of Michigan Health System, Ann Arbor, MI, USA VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Curtis
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Edwin K
authors.initials: EK
authors.lastname: Silverman
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Washko
authors.forename: Dawn
authors.initials: D
authors.lastname: DeMeo
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D017668:Age of Onset; D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed; D014797:Vital Capacity; D044465:White People / Q000706:statistics & numerical data