COPD is a group of diseases, like emphysema and chronic bronchitis, that make it hard to breathe and block the flow of air.

COPD prevalence and outcomes may differ by gender due to structural differences in men and women’s lung airways, according to a new study.

In a large, multicenter study that was published in the journal Radiology, researchers discovered that women’s lung airways were narrower than men’s, even among adults who had never smoked or had smoked fewer than 100 cigarettes in their lifetime. This can increase the risk of lung disease.

COPD is a group of diseases, like emphysema and chronic bronchitis, that make it hard to breathe and block the flow of air. According to the Centers for Disease Control and Prevention, there are more than 15 million Americans who have COPD.

In general, men have a greater rate of diagnosis and mortality, but women are now more likely to have COPD due to changing smoking habits and growing urbanization.

According to the study’s lead author, Surya P. Bhatt, “airway disease may underlie some of the high COPD numbers in women that we are seeing.” “When airways narrow due to cigarette smoking, the impact on symptoms and survival is greater in women than in men.” 

Only a few studies have evaluated distal airways in normal individuals or taken into consideration differences in lung size while making the assumption that women have smaller airways.

The Genetic Epidemiology of COPD (COPDGene) prospective multicenter observational cohort study of smokers, both current and former, as well as never smokers, between the ages of 45 and 80, was conducted at 21 clinical centers across the United States. For this investigation, scientists analyzed data from nearly 10,000 participants enrolled in the study. The researchers looked at data from people who signed up for COPDGene between January 2008 and June 2011 and kept track of them until November 2020.

Seven metrics were used to measure the severity of airway disease on CT scans: airway wall thickness, wall area percent, Pi10 (the square root of the wall thickness of a hypothetical airway with an internal perimeter of 10 mm), lumen diameter, airway volume, total airway count, and airway fractal dimension for airway lumen.

Each airway metric was computed and corrected for total lung capacity, age, height, race, BMI, pack-years of smoking, and other factors.

“The growth of airways and lungs in early life is generally more proportionate in women than in men,” adds Dr. Bhatt.

Men had thicker airway walls than women in 420 never-smokers, according to CT scans, however after taking height and lung capacity into consideration, women’s airway lumen measurements were smaller than men’s.

Men exhibited thicker walls whereas women had narrower segmental lumen diameters in 9,363 present and previous smokers. In comparison to men, women experienced worse lung function, more dyspnea (breathlessness), poorer respiratory quality of life, a shorter six-minute walk distance, and worse survival with each unit change in the airway metrics (higher wall or lower lumen measure).

“The differences in airway dimensions even after adjusting for height and lung size, and the greater impact of changes in airway size on clinical outcomes in women, was remarkable in that women appear to have a lower reserve against developing airway disease and COPD,” notes Dr. Bhatt.

Dr. Bhatt pointed out that the findings suggests that gender disparities must to be taken into account while creating novel treatments for airway disease.

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