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

M. Ekstrom, L. Schioler, R. Gronseth, A. Johannessen, C. Svanes, B. Leynaert, D. Jarvis, T. Gislason, P. Demoly, N. Probst-Hensch, I. Pin, A. G. Corsico, B. Forsberg, J. Heinrich, D. Nowak, C. Raherison-Semjen, S. C. Dharmage, G. Trucco, I. Urrutia, J. Martinez-Moratalla Rovira & 3 others J. L. Sanchez-Ramos, C. Janson, K. Toren

Research output: Contribution to journalArticle

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.
Original languageEnglish
Pages (from-to)10.1183/13993003.02047-2016. Print 2017 May
JournalScandinavian Journal of Respiratory Diseases
Volume49
Issue number5
DOIs
Publication statusPublished - May 25 2017

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Sex Characteristics
Dyspnea
Forced Expiratory Volume
Lung
Population
Biomedical Research
Odds Ratio
Vital Capacity
Bronchodilator Agents
Spirometry
European Union
Health Surveys
Cluster Analysis
Body Mass Index
Cross-Sectional Studies
Logistic Models
Smoking
Depression
Health

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Ekstrom, M., Schioler, L., Gronseth, R., Johannessen, A., Svanes, C., Leynaert, B., ... Toren, K. (2017). Absolute values of lung function explain the sex difference in breathlessness in the general population. Scandinavian Journal of Respiratory Diseases, 49(5), 10.1183/13993003.02047-2016. Print 2017 May. https://doi.org/1602047 [pii]

Absolute values of lung function explain the sex difference in breathlessness in the general population. / Ekstrom, M.; Schioler, L.; Gronseth, R.; Johannessen, A.; Svanes, C.; Leynaert, B.; Jarvis, D.; Gislason, T.; Demoly, P.; Probst-Hensch, N.; Pin, I.; Corsico, A. G.; Forsberg, B.; Heinrich, J.; Nowak, D.; Raherison-Semjen, C.; Dharmage, S. C.; Trucco, G.; Urrutia, I.; Rovira, J. Martinez-Moratalla; Sanchez-Ramos, J. L.; Janson, C.; Toren, K.

In: Scandinavian Journal of Respiratory Diseases, Vol. 49, No. 5, 25.05.2017, p. 10.1183/13993003.02047-2016. Print 2017 May.

Research output: Contribution to journalArticle

Ekstrom, M, Schioler, L, Gronseth, R, Johannessen, A, Svanes, C, Leynaert, B, Jarvis, D, Gislason, T, Demoly, P, Probst-Hensch, N, Pin, I, Corsico, AG, Forsberg, B, Heinrich, J, Nowak, D, Raherison-Semjen, C, Dharmage, SC, Trucco, G, Urrutia, I, Rovira, JM-M, Sanchez-Ramos, JL, Janson, C & Toren, K 2017, 'Absolute values of lung function explain the sex difference in breathlessness in the general population', Scandinavian Journal of Respiratory Diseases, vol. 49, no. 5, pp. 10.1183/13993003.02047-2016. Print 2017 May. https://doi.org/1602047 [pii]
Ekstrom M, Schioler L, Gronseth R, Johannessen A, Svanes C, Leynaert B et al. Absolute values of lung function explain the sex difference in breathlessness in the general population. Scandinavian Journal of Respiratory Diseases. 2017 May 25;49(5):10.1183/13993003.02047-2016. Print 2017 May. https://doi.org/1602047 [pii]
Ekstrom, M. ; Schioler, L. ; Gronseth, R. ; Johannessen, A. ; Svanes, C. ; Leynaert, B. ; Jarvis, D. ; Gislason, T. ; Demoly, P. ; Probst-Hensch, N. ; Pin, I. ; Corsico, A. G. ; Forsberg, B. ; Heinrich, J. ; Nowak, D. ; Raherison-Semjen, C. ; Dharmage, S. C. ; Trucco, G. ; Urrutia, I. ; Rovira, J. Martinez-Moratalla ; Sanchez-Ramos, J. L. ; Janson, C. ; Toren, K. / Absolute values of lung function explain the sex difference in breathlessness in the general population. In: Scandinavian Journal of Respiratory Diseases. 2017 ; Vol. 49, No. 5. pp. 10.1183/13993003.02047-2016. Print 2017 May.
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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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T1 - Absolute values of lung function explain the sex difference in breathlessness in the general population

AU - Ekstrom, M.

AU - Schioler, L.

AU - Gronseth, R.

AU - Johannessen, A.

AU - Svanes, C.

AU - Leynaert, B.

AU - Jarvis, D.

AU - Gislason, T.

AU - Demoly, P.

AU - Probst-Hensch, N.

AU - Pin, I.

AU - Corsico, A. G.

AU - Forsberg, B.

AU - Heinrich, J.

AU - Nowak, D.

AU - Raherison-Semjen, C.

AU - Dharmage, S. C.

AU - Trucco, G.

AU - Urrutia, I.

AU - Rovira, J. Martinez-Moratalla

AU - Sanchez-Ramos, J. L.

AU - Janson, C.

AU - Toren, K.

N1 - LR: 20180125; CI: Copyright (c)ERS 2017; GR: G0901214/Medical Research Council/United Kingdom; JID: 8803460; 2016/10/20 00:00 [received]; 2017/01/29 00:00 [accepted]; 2017/05/27 06:00 [entrez]; 2017/05/27 06:00 [pubmed]; 2017/05/27 06:00 [medline]; epublish

PY - 2017/5/25

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N2 - 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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DO - 1602047 [pii]

M3 - Article

VL - 49

SP - 10.1183/13993003.02047-2016. Print 2017 May

JO - European Journal of Respiratory Diseases

JF - European Journal of Respiratory Diseases

SN - 0903-1936

IS - 5

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