Franziska C Trudzinski1, Christina Kellerer2, Rudolf A Jörres3, Peter Alter4, Johanna I Lutter5, Frederik Trinkmann6, Felix J F Herth6, Marion Frankenberger7, Henrik Watz8, Claus F Vogelmeier4, Hans-Ulrich Kauczor9, Tobias Welte10, Jürgen Behr11, Robert Bals12, Kathrin Kahnert11. 1. Department of Pneumology and Critical Care Medicine, Thoraxklinik, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany. Franziska.trudzinski@med.uni-heidelberg.de. 2. School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany. 3. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Ludwig Maximilians University (LMU), Munich, Germany. 4. Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), Philipps University of Marburg (UMR), Marburg, Germany. 5. Institute of Health Economics and Health Care Management, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Helmholtz Zentrum München GmbH - German Research Center for Environmental Health, Munich, Germany. 6. Department of Pneumology and Critical Care Medicine, Thoraxklinik, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany. 7. University Munich, Asklepios Hospital Gauting and Helmholtz Zentrum München, Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), Ludwig-Maximilians University (LMU), Munich, Germany. 8. Pulmonary Research Institute at LungenClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research, Grosshansdorf, Germany. 9. Department of Diagnostic and Interventional Radiology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital of Heidelberg, Heidelberg, Germany. 10. Department of Pneumology, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. 11. Department of Internal Medicine V, Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), University Hospital, Ludwig-Maximilians University (LMU), Munich, Germany. 12. Department of Internal Medicine V, Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany.
Abstract
BACKGROUND: In chronic obstructive pulmonary disease (COPD), gender-specific differences in the prevalence of symptoms and comorbidity are known. RESEARCH QUESTION: We studied whether the relationship between these characteristics depended on gender and carried diagnostic information regarding cardiac comorbidities. STUDY DESIGN AND METHODS: The analysis was based on 2046 patients (GOLD grades 1-4, 795 women; 38.8%) from the COSYCONET COPD cohort. Assessments comprised the determination of clinical history, comorbidities, lung function, COPD Assessment Test (CAT) and modified Medical Research Council dyspnea scale (mMRC). Using multivariate regression analyses, gender-specific differences in the relationship between symptoms, single CAT items, comorbidities and functional alterations were determined. To reveal the relationship to cardiac disease (myocardial infarction, or heart failure, or coronary artery disease) logistic regression analysis was performed separately in men and women. RESULTS: Most functional parameters and comorbidities, as well as CAT items 1 (cough), 2 (phlegm) and 5 (activities), differed significantly (p < 0.05) between men and women. Beyond this, the relationship between functional parameters and comorbidities versus symptoms showed gender-specific differences, especially for single CAT items. In men, item 8 (energy), mMRC, smoking status, BMI, age and spirometric lung function was related to cardiac disease, while in women primarily age was predictive. INTERPRETATION: Gender-specific differences in COPD not only comprised differences in symptoms, comorbidities and functional alterations, but also differences in their mutual relationships. This was reflected in different determinants linked to cardiac disease, thereby indicating that simple diagnostic information might be used differently in men and women. CLINICAL TRIAL REGISTRATION: The cohort study is registered on ClinicalTrials.gov with identifier NCT01245933 and on GermanCTR.de with identifier DRKS00000284, date of registration November 23, 2010. Further information can be obtained on the website http://www.asconet.net .
BACKGROUND: In chronic obstructive pulmonary disease (COPD), gender-specific differences in the prevalence of symptoms and comorbidity are known. RESEARCH QUESTION: We studied whether the relationship between these characteristics depended on gender and carried diagnostic information regarding cardiac comorbidities. STUDY DESIGN AND METHODS: The analysis was based on 2046 patients (GOLD grades 1-4, 795 women; 38.8%) from the COSYCONET COPD cohort. Assessments comprised the determination of clinical history, comorbidities, lung function, COPD Assessment Test (CAT) and modified Medical Research Council dyspnea scale (mMRC). Using multivariate regression analyses, gender-specific differences in the relationship between symptoms, single CAT items, comorbidities and functional alterations were determined. To reveal the relationship to cardiac disease (myocardial infarction, or heart failure, or coronary artery disease) logistic regression analysis was performed separately in men and women. RESULTS: Most functional parameters and comorbidities, as well as CAT items 1 (cough), 2 (phlegm) and 5 (activities), differed significantly (p < 0.05) between men and women. Beyond this, the relationship between functional parameters and comorbidities versus symptoms showed gender-specific differences, especially for single CAT items. In men, item 8 (energy), mMRC, smoking status, BMI, age and spirometric lung function was related to cardiac disease, while in women primarily age was predictive. INTERPRETATION: Gender-specific differences in COPD not only comprised differences in symptoms, comorbidities and functional alterations, but also differences in their mutual relationships. This was reflected in different determinants linked to cardiac disease, thereby indicating that simple diagnostic information might be used differently in men and women. CLINICAL TRIAL REGISTRATION: The cohort study is registered on ClinicalTrials.gov with identifier NCT01245933 and on GermanCTR.de with identifier DRKS00000284, date of registration November 23, 2010. Further information can be obtained on the website http://www.asconet.net .
Authors: Franziska C Trudzinski; Rudolf A Jörres; Peter Alter; Julia Walter; Henrik Watz; Andrea Koch; Matthias John; Marek Lommatzsch; Claus F Vogelmeier; Hans-Ulrich Kauczor; Tobias Welte; Jürgen Behr; Amanda Tufman; Robert Bals; Felix J F Herth; Kathrin Kahnert Journal: Sci Rep Date: 2022-05-24 Impact factor: 4.996