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Gender differences in emphysema phenotypes in non-COPD smokers

: Sverzellati, N.; Calabro, E.; Randi, G.; La Vecchia, C.; Marchiano, A.; Kuhnigk, J.M.; Spagnolo, P.; Zompatori, M.; Pastorino, U.

European Society of Thoracic Imaging -ESTI-:
ESTI 2008, 16th Annual Meeting of the European Society of Thoracic Imaging. Final programme : May 30 - June 1, 2008, Nice, France
Nice: ESTI, 2008
European Society of Thoracic Imaging (Annual Meeting) <16,2008, Nice>
Fraunhofer MEVIS ()

Fulltext of Abstract:
Purpose: Data on gender differences in the emphysema features are available only in patients with chronic obstructive pulmonary disease (COPD). Thereby, the purpose of this study was to weight how gender influences emphysema phenotype, using multi-detector CT (MDCT) derived multiparametric objective measurements in non-COPD smokers.
Material and methods: We retrospectively evaluated both clinical and low-dose MDCT data on 957 heavy smokers (343 women) without clinical evidence of significant airflow obstruction recruited by the Multicentric Italian Lung Detection trial (MILD trial). MDCT scans were analyzed with prototypical emphysema detection software (MeVis, Bremen) which provides a region-based assessment of the following measures: lung volumes, mean lung density, emphysema index and four classes of emphysema clusters with different volumes. For these measures, multiple regression models were applied to assess the effect of gender, after allowance for age, FEV1, body mass index, pack-years, and pulmonary volume. Results: Compared to males, female smokers showed less severe mean MDCT emphysema measurements (p<0.001). However, fitting multivariate regression models, we observed that women, compared to men, exhibited an emphysema phenotype which was more extensive, more heterogeneous in distribution, and characterized by bigger hole sizes in the lower lobes. Conclusion: Men and women seem to respond differently in the type and location of lung damage due to tobacco exposure and this may provide an advance in understanding the pathophysiologic differences between genders.