4 Lung Disease Study Briefs for Primary Care

Sex hormones associated with adult asthma risk. Gender differences in adult asthma presentation are well recognized – the burden is higher among women. A novel study found that elevated free testosterone (T) & estradiol levels were associated with lower asthma risk in women. The authors suggest that testosterone may protect against asthma in women via systemic, airway specific anti-inflammatory effects. Findings were published in the American Journal of Respiratory and Critical Care Medicine, in September 2019.

Study details: Women with serum testosterone levels in the 2nd and 4th quartiles (but not the 3rd) had 30% and 44% significantly lower odds of current asthma vs those with levels in the 1st quartile.

Upping nutrient intake reduces COPD severity in elderly men. In a study published December 13, 2020 in COPD: Journal of Chronic Obstructive Pulmonary Disease, authors found a significant decrease in disease severity among all men in the study with COPD with increased intake of vit A, retinol, beta-carotene, thiamin, riboflavin. Amongmen aged ≥60 years, a significant decrease in disease severity was seen with increased intake of carbohydrate, protein, fiber, thiamin, riboflavin, niacin, and vit C.

Virtual inhaler use training proves an effective proxy. Authors writing in the January 3, 2020 edition of JAMA Network Openexamined the difference in impact on inhaler technique of virtual education--handheld tablet with self-assessment questionnaire (SAQ) before demonstration, narrated video demonstration of correct technique, and post-demo SAQ; up to 3 rounds, repeated as needed, and in-person education--iterative rounds of inhaler technique assessment & education by trained staff. Correct inhaler technique increased similarly before vs after education in virtual (67%) and in-person (66%) groups.

Study details: Correct technique increased similarly before vs after education in virtual (67%; range, 2%-69%) and in-person (66%; range, 17% to 83%) groups, although the difference after intervention exceeded the noninferiority limit (–14%; 95% CI lower bound, –26%).

COPD may help improve CVD risk prediction. Two known independent predictors of CVD, pulse wave velocity (PWV) and total arterial compliance (TAC), were significantly and adversely affected in patients with stable hyperinflated COPD vs a group without COPD and with equivalent global cardiovascular risk. Authors, whose study was published December 13, 2019 online in COPD: Journal of Chronic Obstructive Pulmoary Disease call for COPD to be incorporated into CVD risk stratification tools.

Study details: PWV (P =.033) and TAC (P<.001) were significantly and adversely affected among participants with COPD compared with the control group. Mean difference in PWV equaled an adjusted increase in relative risk for CV events and mortality of 14% and 15%, respectively. QRISK2 significantly associated with PWV in multivariate analysis among the entire cohort.