By Mark Waghorn via SWNS
Women have smaller airways, making them more prone to lung disease, according to new research.
A study found they are thinner and narrower - even after accounting for height and body mass index (BMI).
It even applied to those who had never smoked or smoked fewer that 100 cigarettes in their lifetime.
The finding is based on almost 10,000 adults. It sheds fresh light on rising rates of COPD (chronic obstructive pulmonary disease).
Lead author Professor Surya Bhatt, of the University of Alabama, said: "The prevalence of COPD in women is fast approaching that seen in men, and 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."
The study, published in the journal Radiology, may have implications for lung cancer.
Women develop tumors at a younger age as they are more vulnerable to the deadly side effects of smoking.
An estimated three million Britons are living with COPD - a range of conditions such as emphysema and bronchitis that cause debilitating breathlessness.
Professor Bhatt said: "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."
Striking structural variabilities may explain the increasing prevalence and worse outcomes among women.
Overall, men have higher diagnosis and mortality rates. But urbanization has made COPD more common in women. They are more likely to smoke in towns and cities.
Professor Bhatt and colleagues analyzed data on current, former and never smokers aged 45 to 80 from across the US.
The participants were enrolled in the COPDGene (Genetic Epidemiology of COPD) study from January 2008 to June 2011 and followed up until November 2020.
They underwent CT (computed tomography) scans for a series of measurements including airway wall thickness size and the diameter of a tube called the lumen.
Each metric was calculated and adjusted for age, height, race, BMI, pack years of smoking, current smoking status and total lung capacity.
Professor Bhatt added: "The growth of airways and lungs in early life is generally more proportionate in women than in men."
In 420 never-smokers men had thicker airway walls. In women, lumen dimensions were lower - after accounting for height and total lung capacity.
In 9,363 current and former smokers, men had greater wall thickness. Women had narrower lumens.
A unit change in each of the airway metrics resulted in lower lung function and more shortness of breath, and poorer respiratory quality of life. It also reduced the distance they could walk in six minutes and reduced longevity.
Sex differences should be factored into the development of new therapies for airway disease, according to Professor Bhatt.
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