Gender differences at presentation of idiopathic pulmonary fibrosis in Sweden

BMC Pulm Med. 2019 Nov 27;19(1):222. doi: 10.1186/s12890-019-0994-4.

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) is a disease with poor prognosis mainly affecting males. Differences in clinical presentation between genders may be important both for the diagnostic work-up and for follow-up. In the present study, we therefore explored potential gender differences at presentation in a Swedish cohort of IPF-patients.

Methods: We studied patients included in the Swedish IPF- registry over a three-year period from its launch in 2014. A cross-sectional analysis was performed for data concerning demographics, lung function, 6- min walking test (6MWT) and quality of life (QoL) (King's Brief Interstitial Lung Disease (K-BILD) score).

Results: Three hundred forty- eight patients (250 (72%) males, 98 (28%) females, median age 72 years in both genders) were included in the registry during the study period. Smoking history (N = 169 (68%) vs. N = 53 (54%), p < 0.05), baseline lung function (Forced vital capacity, % of predicted (FVC%): 68.9% ± 14.4 vs. 73.0% ± 17.7, p < 0.05; Total lung capacity, % of predicted (TLC%): 62.2% ± 11.8 vs. 68.6% ± 11.3%, p < 0.001) were significantly different at presentation between males and females, respectively. Comorbidities such as coronary artery disease (OR: 3.5-95% CI: 1.6-7.6) and other cardiovascular diseases (including atrial fibrillation and heart failure) (OR: 3.8-95% CI: 1.9-7.8) also showed significant differences between the genders. The K- BILD showed poor quality of life, but no difference was found between genders in total score (54 ± 11 vs. 54 ± 10, p = 0.61 in males vs. females, respectively).

Conclusions: This study shows that female patients with IPF have a more preserved lung function than males at inclusion, while males have a significant burden of cardiovascular comorbidities. However, QoL and results on the 6MWT did not differ between the groups. These gender differences may be of importance both at diagnosis and follow- up of patients with IPF.

Keywords: Comorbidities; Gender perspective; Idiopathic pulmonary fibrosis; Interstitial lung disease; KBILD; Registry.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / epidemiology*
  • Idiopathic Pulmonary Fibrosis / physiopathology*
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Quality of Life*
  • Registries
  • Regression Analysis
  • Sex Factors*
  • Sweden / epidemiology
  • Total Lung Capacity
  • Vital Capacity

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