Sex Disparity in Severity of Lung Lesions in Newly Identified Tuberculosis Is Age-Associated

Frontiers in Medicine

article

Yue Chu¹  Yonghong Feng²  Adiilah K. Soodeen-Lalloo³  Jin Huang²  Guanghong Yang²  Fengfang Chen¹  Hongyun Yin¹  Wei Sha¹  Xiaochen Huang¹  Jingyun Shi³ 

[1] Shanghai Key Laboratory of Tuberculosis, School of Medicine, Clinical and Research Centre of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University;Key Laboratory of Environment Pollution Monitoring and Disease Control, School of Public Health, Guizhou Medical University, Ministry of Education;Department of Radiology, School of Medicine, Shanghai Pulmonary Hospital, Tongji University

关键词: tuberculosis;    sex bias;    computed tomography;    complement C4;    BMI;   

DOI  :  10.3389/fmed.2019.00163

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: The age-associated characteristic of computed tomography (CT) images of tuberculosis (TB) and the reason for male bias in TB are still not clear. Methods: We compared the CT images, clinical inflammatory indices and sputum bacterial counts between 594 non-smoking men and women with newly diagnosed TB with matched large span of ages from 15 to 92 years old. Logistic regression analyses were used to identify the cavity-associated factors of men and women, separately and in combination. Results: Sputum bacterial counts, ratio of cavities, lung injury scores, and level of C reactive protein were significantly higher in men than in women with ages from 15 to 74, but not in cases older than 75. In CT images, thick walled cavity, cicatricial emphysema and parenchymal bands were present in men at ages of 15–74 more than matched women. Ratios of cases with lobular emphysema and pleural effusion were higher in men after age of 56. While ratios of cases with parenchymal bands, calcification, pleural effusion, pleural thickening, lobular emphysema and bronchovascular distortion increased with aging, those of centrilobular nodules, micronodules and tree in bud decreased with aging in men. Erythrocyte sedimentation rate (ESR) increased with aging, but no differences were found between men and women in ESR or T-SPOT TB tests. Higher complement C4 and lower body mass index in men and positive result in anti-TB antibody test in women were strongly associated with the presence of cavity. Conclusions: The sex bias in TB is age-associated. TB prevention, treatment and research should take differences of sex and age into account.

【 授权许可】

CC BY