Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease.

Subash S Heraganahally,Lisa Sorger,Helmi Ben Saad,Timothy Howarth,James West

doi:10.1371/journal.pone.0263744

Abstract

Studies assessing normative values and sex differences in pulmonary function test parameters (PFTPs) among Indigenous populations are sparse. PFTPs were compared between male and female Indigenous Australian adults with and without chest radiologically proven chronic airway diseases (CADs). 485 adults (56% were female) with no significant difference in age, body mass index or smoking status between sexes were included. Females displayed a higher prevalence of radiology without CADs compared to males (66 vs. 52%, respectively). Among patients without CADs, after adjustment for age, stature and smoking, males displayed significantly higher absolute values of Forced Vital Capacity (FVC) (mean difference, 0.41L (0.21,0.62), p<0.001) and Forced Expiratory Volume in one second (FEV1) (mean difference 0.27L (0.07,0.47), p<0.001), with no significant difference in FEV1/FVC ratio (mean difference -0.02 (-0.06, 0.02), p = 0.174). Male and female patients with radiologically proven CADs demonstrated lower FEV1/FVC values. However, compared to females, males showed significantly greater reductions in pre- [-0.53 (-0.74, -0.32) vs. -0.29 (-0.42, -0.16), p = 0.045] and post- [-0.51 (-0.72, -0.3) vs. -0.27 (-0.39, -0.14), p = 0.049] bronchodilator FEV1. There are significant sex differences in the PFTPs among Indigenous Australians. Recognising these differences may be of value in the accurate diagnosis, management, monitoring and prognostication of CADs in this population.

Highlights

Pulmonary function tests (PFTs) are crucial in the diagnosis, management, monitoring and prognostications of several respiratory disorders [1]
Indigenous Australians are noted to have a higher prevalence of respiratory disorders, in particular, chronic obstructive pulmonary disease (COPD) and bronchiectasis compared to non-Indigenous Australians, and even more so among those living in the Northern Territory (NT) of Australia [13,14,15,16]
Despite literature evidence suggesting that chronic airway diseases (CADs) are highly prevalent in the Indigenous population with significant effects on morbidity and mortality, there appears a substantial gap in knowledge regarding the normative reference PFT values for Indigenous Australians [17]

Summary

Introduction

Pulmonary function tests (PFTs) are crucial in the diagnosis, management, monitoring and prognostications of several respiratory disorders [1]. Earlier published reports have demonstrated sex differences in PFTPs among non-Indigenous ethnic populations [8,9,10]. Indigenous Australians are noted to have a higher prevalence of respiratory disorders, in particular, chronic obstructive pulmonary disease (COPD) and bronchiectasis compared to non-Indigenous Australians, and even more so among those living in the Northern Territory (NT) of Australia [13,14,15,16]. Despite literature evidence suggesting that chronic airway diseases (CADs) are highly prevalent in the Indigenous population with significant effects on morbidity and mortality, there appears a substantial gap in knowledge regarding the normative reference PFT values for Indigenous Australians [17]. Studies assessing normative values and sex differences in pulmonary function test parameters (PFTPs) among Indigenous populations are sparse

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