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Geschlechtsspezifische Aspekte bei der chronisch obstruktiven Lungenerkrankung

Sex-specific aspects of chronic obstructive pulmonary disease

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Zeitschrift für Pneumologie Aims and scope

Zusammenfassung

In den kommenden Jahren wird die Zahl der Fälle von Patienten und Patientinnen mit chronisch obstruktiver Lungenerkrankung (COPD) weiter ansteigen, wobei der Anstieg bei Frauen und in Regionen mit niedrigen und mittleren Einkommen am höchsten ausfallen wird. Bereits heute sind in Deutschland Männer und Frauen gleichermaßen von COPD betroffen. Geschlechtsspezifische Aspekte sind auch im Zusammenhang mit der COPD von Bedeutung. Die englische Sprache unterscheidet zwischen dem biologischen Geschlecht – „sex“ – und dem sozialen Geschlecht – „gender“ – der gesellschaftlich geprägten und individuell erlernten Geschlechterrolle. Bei der COPD sind beide Aspekte relevant und beeinflussen die Pathogenese, die Wahrnehmung der Erkrankung und das Muster der Komorbiditäten, die Einfluss auf die Symptomatik und die Prognose der Erkrankung haben können. Die Untersuchung geschlechtsspezifischer Unterschiede ist komplex, da eine Vielzahl relevanter Faktoren berücksichtigt werden muss und die zur Untersuchung herangezogenen Datenquellen häufig nicht frei von impliziten Verzerrungen sind.

Abstract

The number of cases of patients with chronic obstructive pulmonary disease (COPD) is expected to rise in the years ahead. The greatest increase in COPD cases is expected among women and in low and middle income regions. In Germany, men and women are even now equally affected by COPD. Sex-specific aspects are also important in the context of COPD. The English language differentiates between the biological sex and the social gender of the socially imprinted and individually learned sex role. Both aspects are relevant in COPD and influence the pathogenesis, the perception of the disease and the pattern of comorbidities, which can have an impact on the symptoms and prognosis of the disease. Research on sex and gender-specific differences in COPD is complex because many influencing factors must be considered and the available data sources for the investigation are often not free from implicit biases.

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Literatur

  1. Boers E et al (2023) Global burden of chronic obstructive pulmonary disease through 2050. JAMA Netw Open 6:e2346598. https://doi.org/10.1001/jamanetworkopen.2023.46598

    Article  PubMed  PubMed Central  Google Scholar 

  2. Gillissen A, Randerath W (2023) Weißbuch Lunge 2023 Bd. 5. Deutsche Gesellschaft für Pneumologie, Beatmungsmedizin e. V. und Deutsche Lungenstiftung e.V

    Google Scholar 

  3. Chapman KR, Tashkin DP, Pye DJ (2001) Gender bias in the diagnosis of COPD. Chest 119:1691–1695. https://doi.org/10.1378/chest.119.6.1691

    Article  CAS  PubMed  Google Scholar 

  4. Miravitlles M et al (2006) Attitudes toward the diagnosis of chronic obstructive pulmonary disease in primary care. Arch Bronconeumol 42:3–8. https://doi.org/10.1016/s1579-2129(06)60106-7

    Article  CAS  PubMed  Google Scholar 

  5. Akbarshahi H et al (2020) No gender-related bias in COPD diagnosis and treatment in Sweden: a randomised, controlled, case-based trial. ERJ Open Res. https://doi.org/10.1183/23120541.00342-2020

    Article  PubMed  PubMed Central  Google Scholar 

  6. Somayaji R, Chalmers JD (2022) Just breathe: a review of sex and gender in chronic lung disease. Eur Respir Rev. https://doi.org/10.1183/16000617.0111-2021

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lutter JI et al (2020) Impact of education on COPD severity and all-cause mortality in lifetime never-smokers and longtime ex-smokers: results of the COSYCONET cohort. Int J Chron Obstruct Pulmon Dis 15:2787–2798. https://doi.org/10.2147/COPD.S273839

    Article  PubMed  PubMed Central  Google Scholar 

  8. Stolz D et al (2022) Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission. Lancet 400:921–972. https://doi.org/10.1016/s0140-6736(22)01273-9

    Article  PubMed  Google Scholar 

  9. (GOLD), G. I. f. C. O. L. D. Global Strategy For Prevention, Diagnosis And Management Of COPD: 2024 Report.

  10. Carey MA et al (2007) The impact of sex and sex hormones on lung physiology and disease: lessons from animal studies. Am J Physiol Lung Cell Mol Physiol 293:L272–L278. https://doi.org/10.1152/ajplung.00174.2007

    Article  CAS  PubMed  Google Scholar 

  11. Tam A et al (2011) The role of female hormones on lung function in chronic lung diseases. BMC Womens Health 11:24. https://doi.org/10.1186/1472-6874-11-24

    Article  PubMed  PubMed Central  Google Scholar 

  12. Joo J, Himes B (2021) Gene-based analysis reveals sex-specific genetic risk factors of COPD. AMIA Annu Symp Proc 2021:601–610

    PubMed  Google Scholar 

  13. Alemayohu MA et al (2023) Burden and risk factors of chronic obstructive pulmonary disease in Sub-Saharan African countries, 1990–2019: a systematic analysis for the Global Burden of disease study 2019. EClinicalMedicine 64:102215. https://doi.org/10.1016/j.eclinm.2023.102215

    Article  PubMed  PubMed Central  Google Scholar 

  14. Murgia N, Gambelunghe A (2022) Occupational COPD-The most under-recognized occupational lung disease? Respirology 27:399–410. https://doi.org/10.1111/resp.14272

    Article  PubMed  PubMed Central  Google Scholar 

  15. Dumas O et al (2019) Association of occupational exposure to disinfectants with incidence of chronic obstructive pulmonary disease among US female nurses. JAMA Netw Open 2:e1913563. https://doi.org/10.1001/jamanetworkopen.2019.13563

    Article  PubMed  PubMed Central  Google Scholar 

  16. Peters SA, Huxley RR, Woodward M (2014) Do smoking habits differ between women and men in contemporary Western populations? Evidence from half a million people in the UK Biobank study. Bmj Open 4:e5663. https://doi.org/10.1136/bmjopen-2014-005663

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sorheim IC et al (2010) Gender differences in COPD: are women more susceptible to smoking effects than men? Thorax 65:480–485. https://doi.org/10.1136/thx.2009.122002

    Article  PubMed  Google Scholar 

  18. Prescott E, Bjerg AM, Andersen PK, Lange P, Vestbo J (1997) Gender difference in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal population study. Eur Respir J 10:822–827

    Article  CAS  PubMed  Google Scholar 

  19. Bhatt SP et al (2022) Sex differences in airways at chest CT: results from the COPDgene cohort. Radiology 305:699–708. https://doi.org/10.1148/radiol.212985

    Article  PubMed  Google Scholar 

  20. AWMF. S3-Leitlinie Nationale VersorgungsLeitlinie COPD, 〈www.leitlinien.de/copd. 〉 (2021).

  21. DeMeo DL et al (2018) Women manifest more severe COPD symptoms across the life course. Int J Chron Obstruct Pulmon Dis 13:3021–3029. https://doi.org/10.2147/COPD.S160270

    Article  PubMed  PubMed Central  Google Scholar 

  22. Raherison C et al (2014) Clinical characteristics and quality of life in women with COPD: an observational study. BMC Womens Health 14:31. https://doi.org/10.1186/1472-6874-14-31

    Article  PubMed  PubMed Central  Google Scholar 

  23. Worth H et al (2016) The ‘real-life’ COPD patient in Germany: the DACCORD study. Respir Med 111:64–71. https://doi.org/10.1016/j.rmed.2015.12.010

    Article  PubMed  Google Scholar 

  24. Karch A et al (2016) The German COPD cohort COSYCONET: Aims, methods and descriptive analysis of the study population at baseline. Respir Med 114:27–37. https://doi.org/10.1016/j.rmed.2016.03.008

    Article  PubMed  Google Scholar 

  25. Jorres RA et al (2010) Systemic manifestations and comorbidities in patients with chronic obstructive pulmonary disease (COPD) and their effect on clinical state and course of the disease—an overview of the cohort study COSYCONET. Dtsch Med Wochenschr 135:446–449. https://doi.org/10.1055/s-0030-1249185

    Article  CAS  PubMed  Google Scholar 

  26. Kahnert K et al (2023) What have we learned from the German COPD cohort COSYCONET and where do we go from here? Pneumologie 77:81–93. https://doi.org/10.1055/a-1966-0848

    Article  PubMed  Google Scholar 

  27. Kardos P et al Issues COPD 49:A1754–A1754

  28. Trudzinski FC et al (2023) Gender-specific differences in COPD symptoms and their impact for the diagnosis of cardiac comorbidities. Clin Res Cardiol 112:177–186. https://doi.org/10.1007/s00392-021-01915-x

    Article  PubMed  Google Scholar 

  29. Trudzinski FC et al (2022) Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET. Sci Rep 12:8790. https://doi.org/10.1038/s41598-022-12828-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Divo M et al (2012) Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 186:155–161. https://doi.org/10.1164/rccm.201201-0034OC

    Article  PubMed  Google Scholar 

  31. Lisspers K et al (2019) Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study. Npj Prim Care Respir Med 29:45. https://doi.org/10.1038/s41533-019-0157-3

    Article  PubMed  PubMed Central  Google Scholar 

  32. Jaramillo JD et al (2015) Reduced bone density and vertebral fractures in smokers. Men and COPD patients at increased risk. Ann Am Thorac Soc 12:648–656. https://doi.org/10.1513/AnnalsATS.201412-591OC

    Article  PubMed  PubMed Central  Google Scholar 

  33. Rogliani P, Cavalli F, Ritondo BL, Cazzola M, Calzetta L (2022) Sex differences in adult asthma and COPD therapy: a systematic review. Respir Res 23:222. https://doi.org/10.1186/s12931-022-02140-4

    Article  PubMed  PubMed Central  Google Scholar 

  34. Calverley PM et al (2007) Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med 356:775–789. https://doi.org/10.1056/NEJMoa063070

    Article  CAS  PubMed  Google Scholar 

  35. Antoniu SA (2009) UPLIFT Study: the effects of long-term therapy with inhaled tiotropium in chronic obstructive pulmonary disease. Evaluation of: Tashkin DP, Celli B, Senn S et al.: a 4-year trial of tiotropium in chronic obstructive pulmonary disease. N Engl J Med (2008) 359(15):1543–1554. Expert Opin Pharmacother 10:719–722. https://doi.org/10.1517/14656560902740804

    Article  CAS  PubMed  Google Scholar 

  36. Vogelmeier C et al (2011) Tiotropium versus salmeterol for the prevention of exacerbations of COPD. N Engl J Med 364:1093–1103. https://doi.org/10.1056/NEJMoa1008378

    Article  CAS  PubMed  Google Scholar 

  37. Wedzicha JA et al (2016) Indacaterol-Glycopyrronium versus Salmeterol-Fluticasone for COPD. N Engl J Med 374:2222–2234. https://doi.org/10.1056/NEJMoa1516385

    Article  CAS  PubMed  Google Scholar 

  38. Lipson DA et al (2018) Once-daily single-inhaler triple versus dual therapy in patients with COPD. N Engl J Med 378:1671–1680. https://doi.org/10.1056/NEJMoa1713901

    Article  CAS  PubMed  Google Scholar 

  39. Rabe KF et al (2020) Triple inhaled therapy at two glucocorticoid doses in moderate-to-very-severe COPD. N Engl J Med 383:35–48. https://doi.org/10.1056/NEJMoa1916046

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Franziska Trudzinski.

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F. Trudzinski, K. Kontogianni und K. Kahnert geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autorinnen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Trudzinski, F., Kontogianni, K. & Kahnert, K. Geschlechtsspezifische Aspekte bei der chronisch obstruktiven Lungenerkrankung. Z Pneumologie (2024). https://doi.org/10.1007/s10405-024-00550-3

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