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Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study

BACKGROUND: Women who smoke have higher risk of lung function impairment, COPD and lung cancer than smoking men. An influence of sex hormones has been demonstrated, but the mechanisms are unclear and the associations often subject to confounding. This was a study of wheeze in relation to smoking and...

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Autores principales: Bjerg, Anders, Ekerljung, Linda, Eriksson, Jonas, Ólafsdóttir, Inga Sif, Middelveld, Roelinde, Franklin, Karl A., Forsberg, Bertil, Larsson, Kjell, Lötvall, Jan, Torén, Kjell, Dahlén, Sven-Erik, Lundbäck, Bo, Janson, Christer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554721/
https://www.ncbi.nlm.nih.gov/pubmed/23357876
http://dx.doi.org/10.1371/journal.pone.0054137
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author Bjerg, Anders
Ekerljung, Linda
Eriksson, Jonas
Ólafsdóttir, Inga Sif
Middelveld, Roelinde
Franklin, Karl A.
Forsberg, Bertil
Larsson, Kjell
Lötvall, Jan
Torén, Kjell
Dahlén, Sven-Erik
Lundbäck, Bo
Janson, Christer
author_facet Bjerg, Anders
Ekerljung, Linda
Eriksson, Jonas
Ólafsdóttir, Inga Sif
Middelveld, Roelinde
Franklin, Karl A.
Forsberg, Bertil
Larsson, Kjell
Lötvall, Jan
Torén, Kjell
Dahlén, Sven-Erik
Lundbäck, Bo
Janson, Christer
author_sort Bjerg, Anders
collection PubMed
description BACKGROUND: Women who smoke have higher risk of lung function impairment, COPD and lung cancer than smoking men. An influence of sex hormones has been demonstrated, but the mechanisms are unclear and the associations often subject to confounding. This was a study of wheeze in relation to smoking and sex with adjustment for important confounders. METHODS: In 2008 the Global Allergy and Asthma European Network (GA(2)LEN) questionnaire was mailed to 45.000 Swedes (age 16–75 years), and 26.851 (60%) participated. “Any wheeze”: any wheeze during the last 12 months. “Asthmatic wheeze”: wheeze with breathlessness apart from colds. RESULTS: Any wheeze and asthmatic wheeze was reported by 17.3% and 7.1% of women, vs. 15.8% and 6.1% of men (both p<0.001). Although smoking prevalence was similar in both sexes, men had greater cumulative exposure, 16.2 pack-years vs. 12.8 in women (p<0.001). Most other exposures and characteristics associated with wheeze were significantly overrepresented in men. Adjusted for these potential confounders and pack-years, current smoking was a stronger risk factor for any wheeze in women aged <53 years, adjusted odds ratio (aOR) 1.85 (1.56–2.19) vs. 1.60 (1.30–1.96) in men. Cumulative smoke exposure and current smoking each interacted significantly with female sex, aOR 1.02 per pack-year (p<0.01) and aOR 1.28 (p = 0.04) respectively. Female compared to male current smokers also had greater risk of asthmatic wheeze, aOR 1.53 vs. 1.03, interaction aOR 1.52 (p = 0.02). These interactions were not seen in age ≥53 years. DISCUSSION: In addition to the increased risk of COPD and lung cancer female, compared to male, smokers are at greater risk of significant wheezing symptoms in younger age. This became clearer after adjustment for important confounders including cumulative smoke exposure. Estrogen has previously been shown to increase the bioactivation of several compounds in tobacco smoke, which may enhance smoke-induced airway inflammation in fertile women.
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spelling pubmed-35547212013-01-28 Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study Bjerg, Anders Ekerljung, Linda Eriksson, Jonas Ólafsdóttir, Inga Sif Middelveld, Roelinde Franklin, Karl A. Forsberg, Bertil Larsson, Kjell Lötvall, Jan Torén, Kjell Dahlén, Sven-Erik Lundbäck, Bo Janson, Christer PLoS One Research Article BACKGROUND: Women who smoke have higher risk of lung function impairment, COPD and lung cancer than smoking men. An influence of sex hormones has been demonstrated, but the mechanisms are unclear and the associations often subject to confounding. This was a study of wheeze in relation to smoking and sex with adjustment for important confounders. METHODS: In 2008 the Global Allergy and Asthma European Network (GA(2)LEN) questionnaire was mailed to 45.000 Swedes (age 16–75 years), and 26.851 (60%) participated. “Any wheeze”: any wheeze during the last 12 months. “Asthmatic wheeze”: wheeze with breathlessness apart from colds. RESULTS: Any wheeze and asthmatic wheeze was reported by 17.3% and 7.1% of women, vs. 15.8% and 6.1% of men (both p<0.001). Although smoking prevalence was similar in both sexes, men had greater cumulative exposure, 16.2 pack-years vs. 12.8 in women (p<0.001). Most other exposures and characteristics associated with wheeze were significantly overrepresented in men. Adjusted for these potential confounders and pack-years, current smoking was a stronger risk factor for any wheeze in women aged <53 years, adjusted odds ratio (aOR) 1.85 (1.56–2.19) vs. 1.60 (1.30–1.96) in men. Cumulative smoke exposure and current smoking each interacted significantly with female sex, aOR 1.02 per pack-year (p<0.01) and aOR 1.28 (p = 0.04) respectively. Female compared to male current smokers also had greater risk of asthmatic wheeze, aOR 1.53 vs. 1.03, interaction aOR 1.52 (p = 0.02). These interactions were not seen in age ≥53 years. DISCUSSION: In addition to the increased risk of COPD and lung cancer female, compared to male, smokers are at greater risk of significant wheezing symptoms in younger age. This became clearer after adjustment for important confounders including cumulative smoke exposure. Estrogen has previously been shown to increase the bioactivation of several compounds in tobacco smoke, which may enhance smoke-induced airway inflammation in fertile women. Public Library of Science 2013-01-24 /pmc/articles/PMC3554721/ /pubmed/23357876 http://dx.doi.org/10.1371/journal.pone.0054137 Text en © 2013 Bjerg et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bjerg, Anders
Ekerljung, Linda
Eriksson, Jonas
Ólafsdóttir, Inga Sif
Middelveld, Roelinde
Franklin, Karl A.
Forsberg, Bertil
Larsson, Kjell
Lötvall, Jan
Torén, Kjell
Dahlén, Sven-Erik
Lundbäck, Bo
Janson, Christer
Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
title Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
title_full Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
title_fullStr Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
title_full_unstemmed Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
title_short Higher Risk of Wheeze in Female than Male Smokers. Results from the Swedish GA(2)LEN Study
title_sort higher risk of wheeze in female than male smokers. results from the swedish ga(2)len study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554721/
https://www.ncbi.nlm.nih.gov/pubmed/23357876
http://dx.doi.org/10.1371/journal.pone.0054137
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