Abstract Rationale Asthma affects over 4.7 million children in the US. There are known sex differences in asthma prevalence, but further research is needed to better characterize differences in symptom control, quality of life, and lung function in childhood asthma. Methods As part of a prospective cohort study of the effects of obesity on asthma (GenOAAT), we recruited youth ages 6-20 years. Using data from GeNOAAT participants with asthma, here we evaluate sex differences in asthma morbidity. All participants completed sociodemographic and respiratory health questionnaires, as well as spirometry. Participants with asthma completed the Childhood Asthma Control Test (cACT), the Asthma Therapy Assessment Questionnaire (ATAQ), and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). FEV1, FEV1/FVC, FEF2575 z-scores were calculated using Global Lung Initiative (GLI) equations. We performed multivariable analyses using linear or logistic regression as appropriate for each outcome and analyzed the association of sex after adjustment for age, BMI, and race. Results Among 190 GenOAAT participants, 85 (44 female and 41 male) had asthma, complete questionnaire data, and spirometry z-scores, and were included for analysis. Female participants had significantly lower ACT scores (-2.46 95%CI -4.77, -0.15, p = 0.04) and higher ATAQ scores (mean difference 0.88 95%CI: -0.10, 1.86, p = 0.07) compared to males (see Table). Females also reported significantly more asthma symptoms during the daytime (+0.26 in a 1-4 symptom scale 95%CI 0.03, 0.50, p = 0.02) and worse PAQLQ scores (-0.96 95%CI -1.6, -0.28, p = 0.006). Conversely, males had significantly lower FEV1/FVC ratios (-3.19% 95%CI -5.90%, -0.47%, p = 0.02) than females, with no other significant differences in spirometry measures including FEV1 (p = 0.99), FVC (p = 0.83) or FEF25-75 (p = 0.87). When we categorized asthma control based on cACT scores (≤19 points=poorly controlled vs 19 points=well controlled), we found that males are 3.12 95%CI 0.99, 10.68, p = 0.06 times more likely to have well-controlled asthma. When we categorized quality of life based on PAQLQ (6 points=moderate/severe impairment vs ≥ 6 points=no/minimal impairment), males were 13.5 95%CI 2.54, 119.84, p = 0.01 times more likely to report no/minimal impairment. Conclusions In this cohort, female participants had significantly worse asthma symptom control and quality of life than their male counterparts, suggesting poorer optimization of symptom management. However, males had significantly lower FEV1/FVC, suggesting greater airway obstruction, with no other significant spirometry differences. Next steps include further analysis on the underlying mechanisms driving these sex differences in asthma. Funding: HL149693 (NIH) This abstract is funded by: None
Silva et al. (Fri,) studied this question.