Differences in Nutritional Status and Inflammatory Biomarkers between Female and Male Patients with Bronchiectasis: A Large-Cohort Study

Abstract

We hypothesized that systemic inflammatory and nutritional parameters may differ between male and female patients with non-CF bronchiectasis. In a large patient cohort from the Spanish Online Bronchiectasis Registry (RIBRON), clinical features, systemic inflammatory and nutritional parameters were analyzed in male and female patients with bronchiectasis. Lung function, disease severity using several scores, nutritional status, systemic inflammatory parameters, and multivariate regression analyses were performed to identify differences between male and female patients in the target variables. The number of female patients included in the registry was greater than male patients and they had a less severe disease as measured by all three indices of disease severity, a lower degree of airway obstruction, worse diffusion capacity and airway trapping, better nutritional parameters, and lower levels of inflammatory biomarkers. Multivariate regression analysis evidenced that strong relationships were found between female gender and the following variables: total numbers of leukocytes and neutrophils, hemoglobin, hematocrit, creatinine, and body mass index (BMI). Multivariate regression analyses evidenced that nutritional parameters and inflammatory biomarkers may be reliable indicators of gender-related differences in patients with non-CF bronchiectasis. These findings deserve further attention in follow-up investigations in which the potential predictive value of those biomarkers should be thoroughly explored.

Systemic Inflammatory Biomarkers Define Specific Clusters in Patients with Bronchiectasis: A Large-Cohort Study

“…Such an impairment in the degree of the airway obstruction and diffusion capacity was independent of the presence of COPD, as statistically significant differences were maintained among the three study clusters after excluding the COPD patients from the analysis in all three clusters. These results confirm that the differential phenotypes are associated with bronchiectasis per se rather than with COPD or the degree of the airflow limitation as also previously demonstrated [ 14 , 19 ].…”

“…An external validation cohort aimed to further confirm the results reported herein would also be a matter of investigation in the near future. Differences between male and female patients were also analyzed previously in this registry [ 14 ]. Thus, these differences have not been analyzed in the present investigation.…”

“…Nutritional abnormalities and systemic inflammation are common in patients with bronchiectasis, particularly in male patients compared to females, as demonstrated in a recent study [ 14 ]. Moreover, body composition and systemic inflammation have a prognosis value in other chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD) [ 15 , 16 , 17 ].…”

Respiratory and Peripheral Muscle Weakness and Body Composition Abnormalities in Non-Cystic Fibrosis Bronchiectasis Patients: Gender Differences

“…As such, the following objectives were established. In female and male patients with mild-to-moderate bronchiectasis compared to a group of healthy control subjects, parameters assessing respiratory and peripheral muscle function were determined: (1) maximal inspiratory and expiratory pressures (MIP and MEP, respectively), (2) sniff nasal inspiratory pressure (SNIP), (3) hand grip and quadriceps muscle strengths, (4) body composition, (5) blood analytical biomarkers, and (6) correlations between lung function and the extrapulmonary parameters.…”

“…Extrapulmonary manifestations are common among patients with chronic respiratory diseases, including those with bronchiectasis [ 5 , 6 , 7 , 8 ]. The analysis of skeletal muscle dysfunction and sarcopenia of patients with chronic obstructive pulmonary disease (COPD) have been a matter of research in multiple previous investigations [ 9 , 10 , 11 , 12 , 13 , 14 ].…”