Figures
- FIGURE 1
All-age and sex-based chronic respiratory disease prevalence by country in 1990 and 2017. Reproduced with permission from the Institute of Health Metrics and Evaluation Global Burden of Disease project [18].
- FIGURE 2
Postulated mechanisms by sex for chronic lung disease. Pink: female; blue: male. CFTR: cystic fibrosis transmembrane conductance regulator; IL: interleukin; NTM: non-tuberculous mycobacteria; P. aeruginosa: Pseudomonas aeruginosa; SARS-CoV-2: severe acute respiratory syndrome-coronavirus-2.
Tables
- TABLE 1
Differences in the epidemiology, outcomes and treatment of chronic lung diseases
Disease Epidemiology Phenotype/prognosis Treatment Asthma Childhood boys >girls
Adulthood females >males
Severe asthma females >malesFemales have more non-allergic asthma
Higher frequency of hospitalisation in females
Worse quality of life in femalesFemales may have more Th2 low disease Bronchiectasis ∼70% female globally Males have worse lung function and more severe disease
Worse symptoms, increased cough in females
High frequency of P. aeruginosa and NTM in femalesNo sex-related differences Increased awareness of NTM in females COPD Classically male disease but prevalence increasing in females
Diagnostic bias in favour of malesFemales have more small airways disease, less emphysema, worse quality of life, more anxiety and depression and more rapid lung function decline No sex-related differences in treatment CF Equal disease prevalence (genetic)
Diagnostic bias in favour of malesDecreased survival in females
Greater rate of pulmonary exacerbations (post-puberty)
Earlier acquisition of P. aeruginosa in females (and greater lung function decline)
Worse quality of life, greater depression in femalesDiscouragement of treatment, acceptance of being underweight in young females IPF Greater prevalence in males Improved post-transplant outcomes, survival in females
Greater symptom burden and worse health-related quality of life in femalesNo data PAH Greater prevalence in females Decreased survival in males (“oestrogen paradox”) Sex-related differences in response to commonly used therapies SBD Greater prevalence in males; middle-aged men thought to be most vulnerable
Diagnostic bias in favour of malesDiffering symptoms between males and females
Greater severity in males
Susceptibility may increase in females with obesity, pregnancy, menopause; maternal SBD may impact neonatal outcomesNo data COPD: chronic obstructive pulmonary disease; CF: cystic fibrosis; IPF: interstitial pulmonary fibrosis; NTM: non-tuberculous mycobacteria; P. aeruginosa: Pseudomonas aeruginosa; PAH: pulmonary arterial hypertension; SBD: sleep-related breathing disorders.
