COPD in women: a particular phenotype

Background: Worldwide, COPD is an illness which remains under-diagnosed in women. Aim: To describe the characteristics of COPD in women and to compare it with COPD in men. Methods: Retrospective and comparative study between a group of women with COPD and a group of known control men COPD followed at the respiratory diseases center of Ariana (Tunisia). The following variables were collected: age, sex, BMI, smoking or exposure to wood smoke, severity of COPD, dyspnea (mMRC scale), co-morbidities and spirometric data. Result: This study included 166 cases of COPD patients divided into one male group: 86 cases and one female group: 80 cases. The average age was higher in the female group (60 ± 13 vs. 65 ± 11 years). The average rate of smoking was higher in male group (59 ± 17 vs 8.9 ± 12 pack-year). COPD in the women’s group was related to exposure to wood smoke in 75% of cases with an average exposure of 23 ± 17 years. The presence of co-morbidities was greater in the female group (52.5% vs 34.8%). The mean stage of dyspnea was more marked in the female group (2.2 ± 1.1 vs 1.96 ± 1.2) and 52.5% of women were in stage 1 or 2 of dyspnea compared to 65.3% of men at stage 3 or 4. Mean FEV1 was higher in the female group (59 ± 2% vs 43 ± 19%). COPD in the female group was less severe: 61.3% of the women were in the GOLD stage 1 or 2 against 44% of the men and 6.3% of the women were in the GOLD stage 4 against 20% of the men. Conclusion: In our country, COPD in wemen is usually caused by exposure to wood smoke. This study reveals that COPD in women is a particular phenotype of this disease characterized by the frequency of comorbidities, a higher age, a higher stage of dyspnea and a less serious functional impact compared to COPD in men.