XXXX male-to-female ratios increase with age: French nationwide study and meta-analysis.

@entity1 @entity191
BACKGROUND: @entity191 ( @entity191 ) is 1.5 times more frequent in @entity1 than @entity1 . Whether age modifies this ratio is unclear. We examined whether male-to-female (M-F) ratios change with age through a French nationwide prevalence/incidence study (2010) and a meta-analysis of incidence studies. METHODS: We used French national drug claims databases to identify @entity191 cases using a validated algorithm. We computed M-F prevalence/incidence ratios overall and by age using Poisson regression. Ratios were regressed on age to estimate their annual change. We identified all @entity191 incidence studies with age/sex-specific data, and performed a meta-analysis of M-F ratios. RESULTS: On the basis of 149 672 prevalent (50% @entity1 ) and 25 438 incident (49% @entity1 ) cases, age-standardised rates were higher in @entity1 (prevalence=2.865/1000; incidence=0.490/1000 @entity1 -years) than @entity1 (prevalence=1.934/1000; incidence=0.328/1000 @entity1 -years). The overall M-F ratio was 1.48 for prevalence and 1.49 for incidence. Prevalence and incidence M-F ratios increased by 0.05 and 0.14, respectively, per 10 years of age. Incidence was similar in @entity1 and @entity1 under 50 years (M-F ratio <1.2, p>0.20), and over 1.6 (p<0.001) times higher in @entity1 than @entity1 above 80 years (p trend <0.001). A meta-analysis of 22 incidence studies (14 126 cases, 46% @entity1 ) confirmed that M- F ratios increased with age (0.26 per 10 years, p trend=0.005). CONCLUSIONS: Age-increasing M-F ratios suggest that @entity191 aetiology changes with age. Sex-related risk/protective factors may play a different role across the continuum of age at onset. This finding may inform aetiological @entity191 research.
