Predictive Factors of Non-Control of Asthma in Moroccan Women about 50 Cases Using a Regression Logistic Model
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Abstract
Asthma is a chronic lung affection, caused by inflammation and a narrowing of the airways, leading to a variable combination of shortness of breath, cough, wheeze and chest tightness. Known as a benign disease, but can severely affect patient’s quality of life and might be fatal if not controlled. As mentioned by the World Health Organization, asthma affected an estimated 300 million people and caused 455 000 deaths. All ages and gender may have asthma. Nonetheless literature data suggest that asthma has a higher incidence in females, particularly at certain stage of pubertal development. Besides, women are more likely to have severe asthma and a later onset of asthma compared to men. Numerous hypotheses have tried to explain this fact. There are not yet final data available in the literature on the role of gender in the pathogenesis of asthma and different behavior in females.
The purpose of this study is to describe then analyze the different factors influencing asthma control in women. This is a retrospective, analytical and descriptive study over a period of 3 years (between 2020 and 2022), involving 50 women with asthma followed in allergology consultation at the Pulmonology Department 20 August 1953, University Hospital Center IBN ROCHD, Casablanca, Morocco.
The age range was between 14 years and 41 years old. 54% of patients were postmenopausal compared to 46% women in young age. As characteristics of our patients, 84% had atopy, 72% had gastroesophageal reflux disease, 32% had vitamin D deficiency, and 13% had Fernand Widal syndrome. Asthma was controlled in 48% of cases and uncontrolled in 52%. Univariate analysis of predictors of asthma control showed that there was a significant association between menopause, vitamin D, gastroesophageal reflux disease, psychiatric disorders, and medication adherence with asthma control. Menopause increases the risk of having uncontrolled asthma with an OR of 12.6. Women with normal vitamine D level had a lower risk of having uncontrolled asthma with an OR of 0.125. Multivariate analysis of predictors of asthma control showed that there is a significant association between menopause and asthma control. Postmenopausal women are more likely to have uncontrolled asthma with an OR equal to 0.005 adjusted for vitamin D, gastroesophageal reflux disease, psychiatric disorders, and medication adherence. Compliant patient has a lower risk to develop an uncontrolled asthma with an OR equal to 0.08 adjusted for menopause, vitamin D, gastroesophageal reflux disease and psychiatric disorders.
The control of asthma in women is peculiar and may be influenced by hormonal and environmental factors. This notion is important to consider in the follow-up and management of female asthma.
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References
2. Cut C, et al. Particularities of female asthma: what is the relationship with hormonal status? Journal of Respiratory Diseases (2014),
3. Townsend EA, Miller VM, Prakash YS. Sex differences and sex steroids in lung health and disease. Endocr Rev 2012; 33:1—47
4. Hancox RJMB, Poulton R, Taylor DR, et al. Sex differences in the relation between body mass index and asthma and atopy in a birth cohort. Am J Respir Crit Care Med 2005; 171:440
5. Svanes C, Real FG, Gislason T, et al. Association of asthma and hay fever with irregular menstruation. Thorax 2005; 60:445—50.
6. Leynaert B, Bousquet J, Henry C, Liard R, Neukirch F. Is bronchial hyperresponsiveness more frequent in women than in men? A population- based study. Am J Respir Crit Care Med 1997; 156:1413-20.
7. Bloom CI, Nissen F, Douglas IJ, Smeeth L, Cullinan P, Quint JK. Exacerbation risk and characterisation of the UK's asthma population from infants to old age. Thorax 2018 ;73 :313-20
8. Romieu I, Fabre A, Fournier A, et al. Postmenopausal hormone therapy and asthma onset in the E3 N cohort. Thorax 2010; 65:292—7.
9. Tiutio Luliana.Asthma in women over time, towards personalized management. Sanofi Campus 2023
10. Balzano G, Fuschillo S, De Angelis E, et al. Persistent airway inflammation and high exacerbation rate in asthma that starts at menopause. Monaldi Arch Chest Dis 2007; 67:13541.
11. Prudhomme A, Frys S, Tillie-Leblond I. Exacerbations of asthma in pregnant women. Rev Mal Respir 2011; 28:834—8.
12. Rey E, Boulet LP. Asthma in pregnancy. BMJ 2007; 334: 582—5.
13. Murphy VE, Clifton VL, Gibson PG. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax 2006; 61:169—76.
14. Shwe Sin Win. Cross-sectional associations of vitamin D status with asthma prevalence, exacerbations, and control in New Zealand adults 10.1016/j.jsbmb.2018
15. Abdelghani Yagoubi.Does omeprazole improve asthma control in poorly controlled asthmatic children with gastroesophageal reflux disease? Journal of Asthma 2021
16. Teague WG, Phillips BR, Fahy JV, Wenzel SE, Fitzpatrick AM, Moore WC, et al. Baseline Features of the Severe Asthma Research Program (SARP III) Cohort:Differences with Age. J Allergy Clin Immunol Pract 2018; 6:545-54 e4
17. Taylor B, Mannino D, Brown C, Crocker D, Twum-Baah N, Holguin F. Body mass index and asthma severity in the National Asthma Survey. Thorax 2008; 63:14-20
18. Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med 2012; 18:716-25.