Absolute lung size and the sex difference in breathlessness in the general population

Research output: Contribution to journalArticle


Background Breathlessness is associated with major adverse health outcomes and is twice as common in women as men in the general population. We evaluated whether this is related to their lower absolute lung volumes. Methods Cross-sectional analysis of the population-based Swedish CardioPulmonarybioImage Study (SCAPIS) Pilot, including static spirometry and diffusing capacity (n = 1,013; 49% women). Breathlessness was measured using the modified Medical Research Council (mMRC) scale and analyzed using ordinal logistic regression adjusting for age, pack-years of smoking, body mass index, chronic airway limitation, asthma, chronic bronchitis, depression and anxiety in all models. Results Breathlessness was twice as common in women as in men; adjusted odds ratio (OR) 2.20 (95% confidence interval, 1.32−3.66). Lower absolute lung volumes were associated with increased breathlessness prevalence in both men and women. The sex difference in breathlessness was unchanged when adjusting for lung function in %predicted, but disappeared when controlling for absolute values of total lung capacity (OR 1.12; 0.59−2.15), inspiratory capacity (OR 1.26; 0.68−2.35), forced vital capacity (OR 0.84; 0.42−1.66), forced expiratory volume in one second (OR 0.70; 0.36−1.35) or lung diffusing capacity (OR 1.07; 0.58−1.97). Conclusion In the general population, the markedly higher prevalence of breathlessness in women is related to their smaller absolute lung volumes.


  • Magnus Ekström
  • Josefin Sundh
  • Linus Schiöler
  • Eva Lindberg
  • Annika Rosengren
  • Göran Bergström
  • Oskar Angerås
  • Jan Hedner
  • John Brandberg
  • Björn Bake
  • Kjell Torén
External organisations
  • Örebro University
  • Uppsala University
  • Sahlgrenska University Hospital
  • University of Gothenburg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Respiratory Medicine and Allergy
Original languageEnglish
Article numbere0190876
JournalPLoS ONE
Issue number1
Publication statusPublished - 2018 Jan 1
Publication categoryResearch