Differences Between Men and Women with Chronic Obstructive Pulmonary Disease

Global, regional, and national burden of chronic obstructive pulmonary disease and its attributable risk factors from 1990 to 2021: an analysis for the Global Burden of Disease Study 2021

BACKGROUND

Chronic obstructive pulmonary disease (COPD) continues to be a significant issue, leading to premature death or reduced quality of life. It's important to assess the current burden of COPD and its risk factors on a geographical basis to guide health policy.

METHODS

Data on the prevalence, deaths, and disability-adjusted life years (DALYs) related to COPD, and risk-attributable burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database. The relationship between COPD DALYs and the sociodemographic index (SDI) was estimated using Smoothing Splines models.

RESULTS

Between 1990 and 2021, the changes were -1.46% (95% uncertainty interval [UI] -3.36% to 0.39%) in age-standardized prevalence, -37.12% (-43.37% to -27.68%) in mortality, and -36.98% (-42.37% to -28.54%) in DALYs rate. In 2021, a total of 213.39 million prevalent cases of COPD were estimated. The age-standardized prevalence of COPD increased with age and was more common in males. The age-standardized COPD DALYs had a reversed U-shaped relationship with SDI at the regional level, with the highest burden at an SDI of about 0.45. At the global level, smoking had the highest influence on COPD DALYs, accounting for 34.8%, followed by ambient particulate matter pollution (22.2%), household air pollution from solid fuels (19.5%), and occupational particulate matter, gases, and fumes (15.8%).

CONCLUSIONS

The overall burden of COPD has been increasing despite improvements in some rates since 1990. It's crucial to focus on interventions such as smoking cessation and addressing environmental and occupational exposures.

Risk Factors for Adults with Chronic Obstructive Pulmonary Disease in the United States, Utilizing State-Based Surveillance

Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous condition. Exposure to tobacco smoke and air pollutants are key risk factors for COPD development; however, other risk factors include race/ethnicity, sex of adults, a history of asthma, occupational exposures, and chronic respiratory infections. Data for the current study were from the 2022 Behavioral Risk Factor Surveillance Survey. Chi-squares and multinomial logistic regression analyses, adjusted with the survey's sampling weight, were used to examine how critical health indicators impacted a COPD diagnosis. Participants (N = 311,175) were adults aged 45 years and older. Adjusted multinomial regression analyses showed adults who reported asthma, current and former smoking, poor physical health, depression, less physical activity, and fatigue were more likely to report COPD. Those with COPD were more likely to be male than female. Moreover, those with COPD reported higher rates of health insurance coverage, and yet had lower income and more financial difficulty affording a doctor for health services. In a follow up regression analysis, examining racial differences in COPD for participants, American Indian adults had a higher odds of reporting COPD than the "other" race groups. Because COPD remains a leading cause of death and disability in the U.S., and racial disparities persist in respiratory outcomes, continuing to identify risk factors for vulnerable groups could assist health program planners with development of successful health messaging.

Sex modifies the risk of HIV-associated obstructive lung disease in Ugandans postpneumonia

OBJECTIVES

Spirometric abnormalities are frequent, and obstructive lung disease (OLD) is a common comorbidity among people with HIV (PWH). HIV increases the risk of many comorbidities to a greater degree in women than in men. Few studies have evaluated whether sex modifies the HIV-associated risk of OLD.

DESIGN AND METHODS

To evaluate the associations between sex and HIV with abnormal lung function, women and men with and without HIV underwent spirometric testing after completing therapy for pneumonia, including tuberculosis (TB), in Kampala, Uganda. OLD was defined as a postbronchodilator forced expiratory volume in the first second to forced vital capacity (FEV 1 /FVC) ratio less than 0.70. Associations between sex, HIV, and lung function were evaluated using multivariable regression models including sex-by-HIV interaction terms after adjusting for age, BMI, smoking status, and TB status.

RESULTS

Among 348 participants, 147 (42%) were women and 135 (39%) were HIV-positive. Sixteen (11%) women and 23 men (11%) had OLD. The HIV-sex interaction was significant for obstructive lung disease ( P  = 0.04). In the adjusted stratified analysis, women with HIV had 3.44 (95% CI 1.11-12.0; P  = 0.04) increased odds of having OLD compared with men with HIV. Women without HIV did not have increased odds of having OLD compared with men without HIV.

CONCLUSION

HIV appears to increase the risk of OLD to a greater degree in women than in men in an urban Ugandan setting. The mechanistic explanation for this interaction by sex remains unclear and warrants further study.

The Role of Sex Differences in Bone Health and Healing

Fracture healing is a long-term and complex process influenced by a huge variety of factors. Among these, there is a sex/gender disparity. Based on significant differences observed in the outcome of bone healing in males and females, in the present review, we report the main findings, hypotheses and pitfalls that could lead to these differences. In particular, the role of sex hormones and inflammation has been reported to have a role in the observed less efficient bone healing in females in comparison with that observed in males. In addition, estrogen-induced cellular processes such as autophagic cell cycle impairment and molecular signals suppressing cell cycle progression seem also to play a role in female fracture healing delay. In conclusion, it seems conceivable that a complex framework of events could contribute to the female bias in bone healing, and we suggest that a reappraisal of the compelling factors could contribute to the mitigation of sex/gender disparity and improve bone healing outcomes.

Prevalence of Chronic Obstructive Pulmonary Disease in an Urban Area. Changes in COPD Ten Years on

Purpose

The prevalence of Chronic obstructive pulmonary disease (COPD) in Spain has been evaluated in the last ten years by EPISCAN in 2007 and EPISCAN II in 2017. This study describes changes in the prevalence of COPD in an urban region of Spain in the last 10 years, its risk factors and underdiagnosis.

Patients and Methods

Participants from the Autonomous Community of Madrid (Spain) were selected from both studies up to the age of 80 years. A descriptive analysis of their sociodemographic and clinical characteristics, as well as by gender, was conducted. COPD was defined by a post-bronchodilator ratio <0.70.

Results

The prevalence of COPD in the Autonomous Community of Madrid increased non-significantly from 11.0% (95% CI: 8.9–13.5%) to 12.1% (95% CI: 9.6–15.1, p=0.612). However, the prevalence by gender showed an increase in women (5.6% to 14.7%, p<0.001) and a decrease in men (17.6% to 9.8%, p=0.08). Underdiagnosis was reduced from 81.0% to 67.9% (p=0.006), although with greater underdiagnosis in women (86.4% in EPISCAN and 100% in EPISCAN II). Smoking was higher in men than in women in EPISCAN (31.2% vs 23.0%, p<0.01) but with no differences by gender in EPISCAN II (25.5% men vs 26.0% women, p=0.146). Age, smoking, low BMI, and a sedentary lifestyle were consistently associated with COPD.

Conclusion

In 10 years in Madrid, there have been no changes in the global prevalence of COPD, but there have been important changes in women, with an increase in its prevalence, smoking habit and underdiagnosis.

Trends in prevalence, mortality, and disability-adjusted life-years relating to chronic obstructive pulmonary disease in Europe: an observational study of the global burden of disease database, 2001-2019

INTRODUCTION

Chronic Obstructive Pulmonary Disease (COPD) is associated with significant mortality and well-defined aetiological factors. Previous reports indicate that mortality from COPD is falling worldwide. This study aims to assess the burden of COPD using prevalence, mortality, and disability-adjusted life years (DALYs) between 2001 and 2019 in 28 European countries (the European Union and the United Kingdom).

METHODS

We extracted COPD data from the Global Burden of Disease database based on the International Classification of Diseases versions 10 (J41, 42, 43, 44 and 47). Age-standardised prevalence rates (ASPRs), age-standardised mortality rates (ASMRs), and DALYs were analysed for European countries by sex for each year (2001-2019) and reported per 100,000 population. We used Joinpoint regression analysis to quantify changing trends in the burden of COPD.

RESULTS

In 2019, the median ASPR across Europe was 3230/100,000 for males and 2202/100,000 for females. Between 2001 and 2019, the median percentage change in ASPR was - 9.7% for males and 4.3% for females. 23/28 countries demonstrated a decrease in ASPRs in males, and 11/28 demonstrated a decrease in females. The median percentage change in ASMR between 2001 and 2019 was - 27.5% for males and - 10.4% for females. 25/28 and 19/28 countries demonstrated a decrease in ASMR in males and females, respectively.

CONCLUSION

In the EU between 2001 and 2019 COPD prevalence has overall increased in females but continues to decrease in males and in some countries, female prevalence now exceeds that of males. COPD mortality in the EU has decreased overall between 2001 and 2019; however, this decrease is not universal, particularly in females, and therefore remains a substantial source of amenable mortality.

Treatable traits in COPD patients

There is no justification for a therapeutic nihilism in clinical practice because current management (pharmacological and non-pharmacological) of the patients with chronic obstructive pulmonary disease according to treatable traits is effective in decreasing their respiratory symptoms, increasing their exercise tolerance and capacity, improving their quality of life, preventing (and treating) many of their exacerbations and decreasing their mortality.

Intelligent Monitoring of Care Status for COPD Patients Based on Deep Learning

To discuss the application method and effect of COPD patients in deep learning in intelligent monitoring, two groups were used under a reasonable selection of antibiotics specifically including reasonable and effective oxygen administration, atomization, sputum discharge treatment, psychotherapy, and rehabilitation training and treatment. Results were indicated, and there were significant differences between the lung function evaluation index and the two groups. Its intelligent monitoring mode was 97.5% and 80.0%, while the red blood cell ratio, arterial oxygen partial pressure (PaO₂), pulse blood oxygen saturation (SpO₂), arterial carbon dioxide partial pressure (PaCO₂), and symptom improvement were better than artificial and were statistically significant (P < 0.05). Therefore, the training of the anti-inspiratory muscle can effectively improve the lung function and dyspnea symptoms of COPD patients at the stable stage, thus greatly improving their respiratory function and ensuring the quality of life of patients, which is worthy of clinical application.

Biological Models of the Lower Human Airways-Challenges and Special Requirements of Human 3D Barrier Models for Biomedical Research

In our review, we want to summarize the current status of the development of airway models and their application in biomedical research. We start with the very well characterized models composed of cell lines and end with the use of organoids. An important aspect is the function of the mucus as a component of the barrier, especially for infection research. Finally, we will explain the need for a nondestructive characterization of the barrier models using TEER measurements and live cell imaging. Here, organ-on-a-chip technology offers a great opportunity for the culture of complex airway models.