Effects of puberty on cystic fibrosis related pulmonary exacerbations in women versus men. Issue 1 (4th March 2013)

• Record Type: Journal Article
• Authors: Sutton, Shelby; Rosenbluth, Daniel; Raghavan, Deepa; Zheng, Jie; Jain, Raksha
• Is Part Of: Pediatric pulmonology. Volume 49:Issue 1(2014:Jan.)
• Page Start: 28
• Page End: 35
• Publication Date: 2013-03-04
• Subjects: Pediatric respiratory diseases -- Periodicals; Pediatrics -- Periodicals; 618.922
• DOI: 10.1002/ppul.22767
• Languages: English
• ISSNs: 8755-6863

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="ppul22767-sec-0001" sec-type="section"> <title>Background</title> <p>Epidemiologic data from studies of airway diseases, such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis indicate a gender disparity where women have worse outcomes. The explanation for this is largely unknown. We hypothesize that female sex hormones play a role in this gender disparity, predisposing women to more exacerbations and decreased lung function post‐puberty.</p> </sec> <sec id="ppul22767-sec-0002" sec-type="section"> <title>Objective</title> <p>In Cystic Fibrosis, to determine if puberty marks a point of increasing exacerbations and decreasing lung function in women relative to men.</p> </sec> <sec id="ppul22767-sec-0003" sec-type="section"> <title>Methods</title> <p>Using the United States Cystic Fibrosis Foundation Patient Registry, we used linear regression to compare lung function and rate of pulmonary exacerbations in men versus women before and after puberty.</p> </sec> <sec id="ppul22767-sec-0004" sec-type="section"> <title>Results</title> <p>Of 5, 137 subjects who met inclusion criteria, 2, 689 were male and 2, 448 were female. Average age of puberty was found to be 13.2 ± 2.2 years in men and 11.2 ± 2.0 years of age in women. Percent predicted FEV1 pre‐ and post‐puberty were no different between males versus females (<italic>P</italic> = 0.44 pre‐puberty and <italic>P</italic> = 0.16 post‐puberty). In contrast, women had a significantly higher rate of pulmonary exacerbations post‐puberty than men (1.17 ± 1.35 exacerbations per year in women versus 0.95 ± 1.27 in men; <italic>P</italic> < 0.001) despite controlling for morphometrics, co‐morbidities, and microbiologic variables.</p> </sec> <sec id="ppul22767-sec-0005" sec-type="section"> <title>Conclusion</title> <p>After puberty, the rate of pulmonary exacerbations increased in adolescent women relative to men with cystic fibrosis, supporting a role for sex hormones in the disease process. Further understanding of the mechanisms that modulate sex hormone receptors in airway disease may serve as future targets for therapy. <bold>Pediatr Pulmonol. 2014; 49:28–35.</bold> © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>