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Absolute values of lung function explain the sex difference in breathlessness in the general population.

Journal article
Authors Magnus Ekström
Linus Schiöler
Rune Grønseth
Ane Johannessen
Cecilie Svanes
Benedicte Leynaert
Deborah Jarvis
Thorarinn Gislason
Pascal Demoly
Nicole Probst-Hensch
Isabelle Pin
Angelo G Corsico
Bertil Forsberg
Joachim Heinrich
Dennis Nowak
Chantal Raherison-Semjen
Shyamali C Dharmage
Giulia Trucco
Isabel Urrutia
Jesús Martinez-Moratalla Rovira
José Luis Sánchez-Ramos
Christer Janson
Kjell Torén
Published in The European respiratory journal
Volume 49
Issue 5
ISSN 1399-3003
Publication year 2017
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Language en
Links dx.doi.org/10.1183/13993003.02047-2...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Health Sciences

Abstract

Activity-related breathlessness is twice as common among females as males in the general population and is associated with adverse health outcomes. We tested whether this sex difference is explained by the lower absolute forced expiratory volume in 1 s (FEV1) or forced vital capacity (FVC) in females.This was a cross-sectional analysis of 3250 subjects (51% female) aged 38-67 years across 13 countries in the population-based third European Community Respiratory Health Survey. Activity-related breathlessness was measured using the modified Medical Research Council (mMRC) scale. Associations with mMRC were analysed using ordered logistic regression clustering on centre, adjusting for post-bronchodilator spirometry, body mass index, pack-years smoking, cardiopulmonary diseases, depression and level of exercise.Activity-related breathlessness (mMRC ≥1) was twice as common in females (27%) as in males (14%) (odds ratio (OR) 2.21, 95% CI 1.79-2.72). The sex difference was not reduced when controlling for FEV1 % predicted (OR 2.33), but disappeared when controlling for absolute FEV1 (OR 0.89, 95% CI 0.69-1.14). Absolute FEV1 explained 98-100% of the sex difference adjusting for confounders. The effect was similar within males and females, when using FVC instead of FEV1 and in healthy never-smokers.The markedly more severe activity-related breathlessness among females in the general population is explained by their smaller spirometric lung volumes.

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