Sex differences in COPD comorbidities

Background: COPD is a major cause of morbidity and mortality worldwide. Comorbidities are very common in COPD patients and increase the risk of exacerbation, polypharmacy, and mortality. Despite in some parts of the world, female mortality exceeds that for men, the distribution of comorbidities by sex in COPD has been poorly investigated. Aims and objectives: to assess the prevalence of comorbidities by sex in a cohort of COPD patients. Methods: In 274 COPD outpatients (67% men, 33% women) were collected: age, BMI, smoking history, annual exacerbations, spirometry and comorbidities (hypertension, heart disease, heart failure, diabetes, dyslipidemia, anxiety/depression, cerebrovascular disease, osteoporosis, gastroesophageal reflux disease, OSAS, thyroid disease, nutritional deficiency). Results: As compared to men, women had significantly lower age (68 vs 70 yrs), BMI (25.7 vs 27.9 kg/m 2 ), higher prevalence of never smokers (19% vs 2%), and of annual exacerbations (1.7 vs 1.2). Among comorbidities, women had higher prevalence of anxiety/depression (34% vs 21%), valvular heart disease (41% vs 25%), thyroid disease (28% vs 12%) and lower prevalence of ischemic heart disease (10 vs 21%), cerebrovascular disease (5% vs 16%), and neoplastic disease (8% vs 19%. Women had also lower 25-OH vitamin D (13.7 vs 17.4 ng/ml) and ferritin (110 vs 172 ng/ml). No difference in GOLD class distribution was found between men and women. Conclusions: COPD women, as compared with men, had similar distribution of disease severity and more exacerbations, despite milder smoking history. Women had higher prevalence of anxiety, valvular disease, thyroid disease, but lower prevalence of ischemic heart and cerebral disease and neoplastic disease.