Sexually dimorphic response to tobacco exposure in COPD: a systematic review and meta-analysis
Abstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous, progressive pulmonary disorder with persistent respiratory symptoms resulting from abnormalities in the airways and/or alveoli and was prevalent globally in 10.3% of people aged 30-79 years in 2019. The prevalence of COPD has increased rapidly in women in the past decade. This may be due to increased tobacco use, but may also involve sex-specific factors.
PURPOSE: To evaluate the prevalence of COPD in the context of sex and tobacco exposure.
DATA SOURCES AND SEARCHES: Comprehensive searches of MEDLINE (OVID), EMBASE and CENTRAL were conducted for articles published from inception to July 22, 2022.
STUDY SELECTION: We independently evaluated titles, abstracts and full-text articles in a duplicated two-staged process. Studies were included if they reported the prevalence of COPD as a primary outcome in the context of sex and tobacco exposure.
DATA SYNTHESIS AND ANALYSIS: Pooled analysis was conducted with Review Manager 5, and heterogeneity was assessed with the I2 statistic. For 163, 450 individuals the prevalence of COPD was 3.5-20.7% in males and 6.3-18.5% in females, and we observed a non-statistically significant difference of 1.53% [95% CI: -5.83, 8.89] (p = 0.68) in females compared to males with tobacco exposure (Tau2 = 54.02; Chi2 = 53.15; df = 4 (P < 0.00001); I2 = 92%). Females with COPD had earlier mortality, greater co-morbidities involving cardiovascular disease and others, and decreased…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 163 participants or records.
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