Gender-specific differences of bronchial asthma phenotypes in children depending on puberty status

Abstract

Оbjective of the study was to evaluate if sex-based differences exist in clinical and epidemiologic characteristics of bronchial asthma (BA) in children before and after puberty. Material and methods. 120 school-age children with persistent BA (80 of whom – males and 49 – pre-puberty individuals), have been examined in observational study with cross-section design. Inclusion criteria: age from 6 to 18 years old; a diagnosis of BA for at least one year; informed consent of parents and children. Exclusion criteria: orphans; the presence of any other chronic lung disease. The first group included 49 patients before puberty, the second clinical group was formed of 71 patients after puberty onset. The clinical anamnestic, allergologic, spirometric and statistical methods of research were used. Results. Early onset BA non significantly associated with male gender before puberty and late onset BA phenotype slightly predominated in post-pubertal females (RR=1,3; 95%CI:0,6-3,0). Regardless of gender non-severe BA predominated in pre-puberty period and post-puberty period associated with non significantly increased risk of severe BA phenotype (RR=1,6; 95%CI:0,5-5,1 and RR=1,4; 95%CI:0,8-2,5 in females and males respectively). Atopic BA predominated in males and non-atopic phenotype associated with female gender both in pre- and postpuberty. Phenotype of BA with exercise induced bronchoconstriction was equally distributed among both sexes regardless of puberty status. After puberty risk of hospitalization to emergency department due to BA exacerbation in males significantly decreased (RR=0,6; 95%CI:0,4-0,8), while in females such risk slightly increased (RR=1,4; 95%CI:0,7-2,7). Conclusion. Male gender slightly associated with atopic phenotype, early onset BA before puberty and significantly reduced risk of hospitalization due to exacerbation after puberty. Female gender slightly associated with non-atopic BA phenotype and elevated risk of hospitalization due to BA exacerbation after puberty.