Effects of Endogenous Sex Hormones in Adolescent Asthma

Table 1. SARP III Pediatric sample features compared by sex
	Males (n = 116)	Females (n = 71)		P value
Age, years, mean (± sd)	11.3 (± 2.7)	11.8 (± 3.1)		0.21
Age of asthma diagnosis	3.1 (± 2.7)	3.1 (± 2.7)		0.90
Years since onset of asthma symptoms (asthma duration)	9.0 (± 3.2)	9.4(± 3.5)		0.50
BMI percentile	76.9 (± 26.5)	73.5 (± 27.1)		0.40
Race/ethnicity, n (%)
White non-Hispanic	28 (24)	26 (37)		0.26
African American non-Hispanic	51 (44)	26 (37)
Hispanic	17 (15)	11 (15)
Other	20 (17)	8 (11)
Asthma severity, n (%)
Severe	66 (57)	44 (62)		0.49
Not severe	50 (43)	27 (38)		0.49
Systemic Corticosteroid Treatment (current)	11 (9)	5 (7)		0.56
Systemic Corticosteroid Treatment (past 3 mos)	7 (6)	3 (4)		0.59
High-Dose Inhaled Corticosteroids	82 (71)	50 (70)		0.97
Low-Medium-Dose Inhaled Corticosteroids	23 (20)	14 (20)		0.99
Montelukast (during last 12 months) n(%)	71 (60)	54 (76)		0.03
Long-acting beta agonist	86 (74)	49 (69)		0.45
Atopic sensitization
At Least One Positive Specific IgE (of 15 tests)	106 (93)	64 (91)		0.70
Number of Positive Specific IgEs (of 15 tests). Mean (± sd)	7.0 (4.3)	7.0 (4.9)		0.95
History of atopic dermatitis. n(%)	74 (64)	44 (62)		0.80
Tanner stage, n (%)	Males	Females
Tanner stage, n (%)	Pubic hair	Breast development	Pubic hair
I	67 (58)	14 (20)	24 (34)
II	17 (15)	18 (25)	13 (18)
III	8 (7)	16 (23)	8 (11)
IV	7 (6)	9 (13)	13 (18)
V	17 (15)	14 (20)	13 (18)

Table 2. Lung function by sex and pubertal stage in children 6–18 years with asthma
	Males				Females				Females
	Tanner stages of pubic hair†				Tanner stages of breast development†				Tanner stages of pubic hair†
	1–2 n = 84	3–5 n = 32	Ratio 3–5:1–2	Δ 3–5:1–2	1–2 n = 32	3–5 n = 39	Ratio 3–5:1–2	Δ 3–5:1–2	1–2 n = 37	3–5 n = 34	Ratio 3–5:1–2	Δ 3–5:1–2
Pre-BD FEV1 (%)	89.4 ± 18.5	89.1 ± 16.4	1.00	− 0.3	93.9 ± 13.0	87.2 ± 14.9	0.93	−6.8	90.4 ± 15.2	90.1 ± 13.7	1.00	− 0.3
Max Post-BD FEV1 (%)	103.5 ± 19.3	105.7 ± 10.2	1.02	2.2	109.4 ± 13.1	100.5 ± 13.1	0.92	− 8.9*	106.0 ± 14.4	102.9 ± 13.0	0.97	− 3.1
BD Resp. (% FEV₁ change)	17.3 ± 16.6	21.8 ± 20.8	1.26	4.5	17.2 ± 10.7	17.2 ± 17.5	1.00	−0.0	19.1 ± 17.1	15.2 ± 11.5	0.80	−3.9
Absolute BD Resp. (net FEV₁ change)	14.1 ± 10.3	16.7 ± 11.7	1.18	2.5	15.5 ± 8.3	13.4 ± 9.2	0.86	−2.1	15.7 ± 9.7	12.9 ± 7.6	0.82	−2.8
Pre-BD FVC (%)	101.4 ± 15.9	106.4 ± 16.0	1.05	5.0	106.3 ± 11.6	100.5 ± 12.9	0.94	−5.9*	102.9 ± 13.5	103.3 ± 11.8	1.01	0.4
Max Post-BD FVC (%)	109.2 ± 17.6	112.5 ± 13.8	1.03	3.3	113.8 ± 12.9	104.8 ± 13.7	0.92	−9.0*	110.4 ± 14.9	107.2 ± 13.0	0.97	− 3.2
Pre-BD FEV1/FVC (%)	87.3 ± 10.7	83.5 ± 11.6	0.96	−3.8	87.9 ± 8.4	86.3 ± 10.9	0.98	−1.5	87.2 ± 9.9	86.8 ± 9.9	1.00	−0.4
Max Post-BD FEV1/FVC (%)	94.9 ± 8.8	94.9 ± 7.4	1.00	0.0	97.2 ± 7.6	96.4 ± 8.2	0.99	−0.8	97.1 ± 7.8	96.4 ± 8.1	0.99	− 0.6
PC20 (log 2)	0.3 ± 1.9 n = 35	1.0 ± 3.0 n = 10	3.57	0.7	−0.7 ± 3.6 n = 7	0.0 ± 2.4 n = 15	− 0.05	0.7	− 0.3 ± 3.3 n = 10	−0.1 ± 2.4 n = 12	0.47	0.2

ϯ Cross sectional, based on enrollment examination; *p < 0.05 Tanner Stage 1–2 versus Tanner Stage 3–5

Table 3. ACQ6 by sex, pubertal stage, and asthma severity in children 6–18 years of age
	Males				Females				Females
	Tanner stages of pubic hair†				Tanner stages of breast development†				Tanner stages of pubic hair†
	1–2 n = 84	3–5 n = 32	Ratio 3–5:1–2	Δ 3–5:1–2	1–2 n = 32	3–5 n = 39	Ratio 3–5:1–2	Δ 3–5:1–2	1–2 n = 37	3–5 n = 34	Ratio 3–5:1–2	Δ 3–5:1–2
ACQ6	1.2 ± 0.9	0.8 ± 0.7	0.70	−0.4	1.0 ± 0.8 n = 32	1.3 ± 1.0 n = 39	1.30	0.3*	1.1 ± 0.9 n = 37	1.3 ± 1.0 n = 34	1.24	0.3*
Severe
ACQ6	1.5 ± 0.9 n = 49	0.9 ± 0.6 n = 17	0.63	−0.6*	1.1 ± 1.0 n = 18	1.3 ± 1.0 n = 26	1.18	0.2*	1.1 ± 1.0 n = 21	1.4 ±1.0 n = 23	1.22	0.3*
Non-severe
ACQ6	0.8 ± 0.7 n = 35	0.7 ± 0.9 n = 15	0.94	−0.0	0.9 (0.6), n = 14	1.4 (1.1), n = 13	1.50	0.5*	1.0 (0.7), n = 16	1.3 (1.0), n = 11	1.25	0.3*

*p < 0.05, Tanner Stage I-II compared to Tanner Stage III-V

Table 4. Linear regression analysis of lung function and ACQ6 by sex hormone levels in males 6–18 years with asthma
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Pre-BD FEV₁ (%)	Log (DHEA-S)	9.285	0.011	0.168	0.011
Post-BD FEV₁ (%)	Log (DHEA-S)	9.527	0.006	0.160	0.006
Pre-BD FVC (%)	log (DHEA-S)	9.121	0.007	0.157	0.007
ACQ6	Log (DHEA-S)	−0.008	0.019	0.214	0.018
	Testosterone	−0.005	0.031
	log (DHEA-S) *Testosterone #	0.003	0.05

*Results reflect final results of a model that started with testosterone and DHEA-S. Covariates that were not significantly associated with the outcome in this model were then removed by backward selection and model was re-run with remaining variables. # A log (DHEA-S)* testosterone interaction was found and included in the final model

Table 5. Multi-variable regression analysis of lung function and ACQ6 by sex hormone levels in females 6–18 years with asthma
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Pre-BD FEV₁ (%)	Estradiol	−0.457	0.028	0.209	0.028
Post-BD FEV₁ (%)	Estradiol	−0.454	0.005	0.320	0.005
Pre-BD FVC (%)	Estradiol	−0.351	0.025	0.217	0.025
Post-BD FVC (%)	Estradiol	−0.322	0.015	0.249	0.015
ACQ6	log (DHEA-S)	0.006	0.048	0.173	0.048

*Results reflect final results of a model that started with log (DHEA-S), estradiol, progesterone, and free testosterone as covariates. Covariates that were not significantly associated with the outcome in this model were then removed by backward selection and model was re-run with remaining variables

Table S1. Characteristics of Females Discordant for Breast and Pubic Hair Stages of Pubertal Development
	Breast development > pubic hair (n=1)	Pubic hair > breast development (n=6)	No Discrepancy
Age, mean ± sd	9.3	12.1 ± 0.8	11.9 ± 3.23
Race/ethnicity, n (%)
White non-Hispanic	0 (0)	2 (33)	24 (38)
African American non-Hispanic	1 (100)	3 (50)	22 (34)
Hispanic	0 (0)	1 (17)	10 (16)
Other	0 (0)	0 (0)	8 (13)
Asthma severity, n (%)
Severe	1 (100)	3 (50)	23 (36)
Not severe	0 (0)	3 (50)	41 (64)

Table S2-A-1. Lung Function by Sex and Pubertal Stage in Children 6–18 Years with Asthma BMI ≥ 85%
	Males				Females				Females
	Tanner stages of pubic hair†				Tanner stages of breast development†				Tanner stages of pubic hair†
	1–2 n=49	3–5 n=18	Ratio 3-5: 1-2	Δ 3-5: 1-2	1–2 n=16	3–5 n=21	Ratio 3-5: 1-2	Δ 3–5: 1-2	1–2 n=17	3–5 n=20	Ratio 3-5: 1-2	Δ 3–5: 1-2
Pre-BD FEV1 (%)	91.6 (20.5)	89.0 (19.7)	0.97	-2.6	92.6 (12.1)	90.0 (13.0)	0.97	-2.6	92.5 (11.8)	89.9 (13.4)	0.97	-2.5
Max Post-BD FEV1 (%)	106.5 (21.4)	106.7 (10.5)	1.00	0.3	110.7 (11.7)	102.8 (12.5)	0.93	-7.9*	110.2 (11.5)	102.9 (12.8)	0.93	-7.4*
BD Resp. (% FEV₁ change)	17.9 (16.9)	24.2 (23.4)	1.36	6.4	20.3 (9.4)	14.9 (8.7)	0.74	-5.4	19.9 (9.3)	15.1 (8.9)	0.76	-4.8
Absolute BD Resp. (net FEV₁ change)	14.9 (10.7)	17.7 (11.7)	1.19	2.9	18.1 (6.9)	12.9 (6.4)	0.71	-5.3	17.7 (6.9)	12.9 (6.6)	0.73	-4.8
Pre-BD FVC (%)	104.2 (17.3)	108.2 (18.3)	1.04	4.0	106.4 (12.2)	103.8 (11.9)	0.98	-2.6	105.8 (12.1)	104.2 (12.1)	0.99	-1.6
Max Post-BD FVC (% )	112.4 (19.1)	114.8 (13.7)	1.02	2.4	116.6 (13.4)	108.4 (13.0)	0.93	-8.2	115.6 (13.6)	108.8 (13.2)	0.94	-6.8
Pre-BD FEV1/FVC (%)	86.6 (11.2)	81.7 (11.5)	0.94	-5.0	86.6 (8.5)	86.3 (8.3)	1.00	-0.3	87.1 (8.5)	85.9 (8.3)	0.99	-1.2
Max Post-BD FEV1/FVC (%)	94.3 (8.9)	93.6 (6.8)	0.99	-0.7	96.1 (7.3)	95.2 (7.0)	0.99	-0.9	96.4 (7.2)	94.9 (7.0)	0.98	-1.5
PC20 (log 2)	0.7 (1.6), n=18	1.2 (3.3), n=7	1.70	0.5	1.6 (0.9), n=2	-0.5 (2.8), n=7	-.32	-2.1	1.6 (0.9), n=2	-0.5 (2.8), n=7	-.32	-2.1

ϯ Cross sectional, based on enrollment examination; *p < 0.05 Tanner Stage 1–2 versus Tanner Stage 3–5.

Table S2-A-2. Lung Function by Sex and Pubertal Stage in Children 6–18 Years with Asthma BMI < 85%
	Males				Females				Females
	Tanner stages of pubic hair†				Tanner stages of breast development†				Tanner stages of pubic hair†
	1–2 n=35	3–5 n=14	Ratio 3-5: 1-2	Δ 3-5: 1-2	1–2 n=16	3–5 n=18	Ratio 3-5: 1-2	Δ 3–5: 1-2	1–2 n=37	3–5 n=34	Ratio 3-5: 1-2	Δ 3–5: 1-2
Pre-BD FEV1 (%)	86.3 (15.1)	89.2 (11.7)	1.03	2.9	95.3 (14.2)	83.9 (16.7)	0.88	-11.4*	88.6 (17.8)	90.2 (14.8)	1.02	1.7
Max Post-BD FEV1 (%)	99.3 (15.5)	104.4 (10.1)	1.05	5.1	108.1 (14.7)	97.8 (13.7)	0.90	-10.3*	102.5 (15.9)	103.0 (13.9)	1.01	0.5
BD Resp. (% FEV₁ change)	16.5 (16.3)	18.6 (17.1)	1.13	2.2	14.1 (11.3)	19.9 (24.1)	1.41	5.8	18.5 (21.9)	15.4 (14.9)	0.83	-3.1
Absolute BD Resp. (net FEV₁ change)	13.0 (9.8)	15.3 (12.0)	1.17	2.2	12.8 (8.9)	14.0 (11.8)	1.09	1.2	13.9 (11.5)	12.7 (9.1)	0.92	-1.2
Pre-BD FVC (%)	97.4 (12.9)	104.2 (12.9)	1.07	6.8	106.2 (11.3)	96.6 (13.3)	0.91	-9.7*	100.5 (14.4)	102.1 (11.6)	1.02	1.6
Max Post-BD FVC (% )	104.8 (14.4)	109.6 (14.0)	1.05	4.8	111.1 (12.2)	100.7 (13.6)	0.91	-10.4*	106.0 (14.8)	105.0 (12.8)	0.99	-1.0
Pre-BD FEV1/FVC (%)	88.2 (10.2)	85.9 (11.8)	0.97	-2.4	89.1 (8.4)	86.4 (13.7)	0.97	-2.7	87.4 (11.2)	88.1 (12.2)	1.01	0.7
Max Post-BD FEV1/FVC (%)	95.9 (8.6)	96.6 (8.1)	1.01	0.8	98.3 (8.0)	97.8 (9.4)	1.00	-0.4	97.6 (8.4)	98.7 (9.3)	1.01	1.0
PC20 (log 2)	-0.2 (2.0), n=17	0.5 (3.0), n=3	-3.2	0.7	-1.6 (4.0), n=5	0.5 (2.0), n=8	-.31	2.2	-0.8 (3.6), n=8	0.4 (1.9), n=5	-.53	1.2

ϯ Cross sectional, based on enrollment examination; *p < 0.05 Tanner Stage 1–2 versus Tanner Stage 3–5.

Table S2-B-1. ACQ6 by Sex, Pubertal Stage, and Asthma Severity in Children 6–18 Years of Age BMI ≥ 85%
	Males				Females				Females
	Tanner stages of pubic hair†				Tanner stages of breast development†				Tanner stages of pubic hair†
	1-2 n=49	3-5 n=18	Ratio 3-5: 1-2	Δ 3-5: 1-2	1-2 n=16	3-5 n=21	Ratio 3-5: 1-2	Δ 3-5: 1-2	1-2 n=17	3-5 n=20	Ratio 3-5: 1-2	Δ 3-5: 1-2
ACQ6	1.2 (0.9)	1.0 (0.9)	0.84	-0.2	1.3 (1.0)	1.6 (1.1)	1.27	0.3	1.3 (1.0)	1.6 (1.1)	1.25	0.3
Severe
ACQ6	1.3 (1.0), n=32	0.9 (0.6), n=10	0.69	-0.4	1.5 (1.1), n=11	1.7 (1.1), n=14	1.13	0.2	1.5 (1.1), n=11	1.7 (1.1), n=14	1.13	0.2
Non-severe
ACQ6	0.8 (0.6), n=17	1.0 (1.2), n=8	1.27	0.2	0.8 (0.6), n=5	1.5 (1.3), n=7	1.87	0.7	0.9 (0.7), n=6	1.5 (1.4), n=6	1.56	0.5

*p < 0.05, Tanner Stage I-II compared to Tanner Stage III-V.

Table S2-B-2. ACQ6 by Sex, Pubertal Stage, and Asthma Severity in Children 6–18 Years of Age BMI < 85%
	Males				Females				Females
	Tanner stages of pubic hair†				Tanner stages of breast development†				Tanner stages of pubic hair†
	1-2 n=35	3-5 n=14	Ratio 3-5: 1-2	Δ 3-5: 1-2	1-2 n=16	3-5 n=18	Ratio 3-5: 1-2	Δ 3-5: 1-2	1-2 n=20	3-5 n=14	Ratio 3-5: 1-2	Δ 3-5: 1-2
ACQ6	1.2 (1.0)	0.7 (0.5)	0.54	-0.6*	0.8 (0.6)	1.0 (0.8)	1.29	0.2	0.9 (0.8)	1.0 (0.7)	1.07	0.1
Severe
ACQ6	1.7 (0.8), n=17	0.9 (0.6), n=7	0.53	-0.8*	0.7 (0.6), n=8	1.0 (0.8), n=11	1.50	0.3	0.8 (0.7), n=11	1.0 (0.8), n=8	1.30	0.2
Non-severe
ACQ6	0.8 (0.9), n=18	0.4 (0.3), n=7	0.53	-0.4	0.9 (0.6), n=8	1.0 (0.8), n=7	1.14	0.1	1.0 (0.9), n=9	0.9 (0.4), n=6	0.86	-0.1

*p < 0.05, Tanner Stage I-II compared to Tanner Stage III-V.

Table S3-A-1. Linear Regression Analysis of Lung Function and ACQ6 by Sex Hormone Levels in Males 6–18 Years with Asthma and BMI >85 percentile (n=23)
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Pre-BD FEV₁ (%)	Log (DHEA-S)	11.721	0.029	0.207	0.029
Post-BD FEV₁ (%)	Log (DHEA-S)	12.285	0.0258	0.215	0.0258
Pre-BD FVC (%)	log (DHEA-S)	12.44	0.022	0.225	0.022
ACQ6	Log (DHEA-S)	-0.674	0.003	0.35	0.003

*Results reflect final results of a model that started with testosterone and DHEA-S. Covariates that were not significantly associated with the outcome in this model were then removed by backward selection and model was re-run with remaining variables.

Table S3-A-2. Linear Regression Analysis of Lung Function and ACQ6 by Sex Hormone Levels in Males 6–18 Years with Asthma and BMI <85 percentile (n=22)
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Pre-BD FEV₁ (%)	Log (DHEA-S)	4.114	0.33	0.048	0.33
Post-BD FEV₁ (%)	Log (DHEA-S)	5.55	0.197	0.081	0.197
Pre-BD FVC (%)	log (DHEA-S)	4.083	0.284	0.057	0.284
ACQ6	Log (DHEA-S)	-0.272	0.356	0.043	0.356

*Results reflect final results of a model that started with testosterone and DHEA-S. Covariates that were not significantly associated with the outcome in this model were then removed by backward selection and model was re-run with remaining variables.

Table S3-B-1. Multi-Variable Regression Analysis of Lung Function and ACQ6 by Sex Hormone Levels in Females 6–18 Years with Asthma and BMI >85 percentile (n=13)
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Pre-BD FEV₁ (%)	Estradiol	-0.065	0.637	0.021	0.637
Post-BD FEV₁ (%)	Estradiol	0.0347	0.749	0.01	0.749
Pre-BD FVC (%)	Estradiol	-0.146	0.228	0.129	0.146
Post-BD FVC (%)	log (DHEA-S)	-5.907	0.055	0.295	0.055
ACQ6	log (DHEA-S)	0.541	0.228	0.129	0.228

*Results reflect final results of a model that started with log (DHEA-S), estradiol, progesterone, and free testosterone as covariates. Covariates that were not significantly associated with the outcome in this model were then removed by backward selection and model was re-run with remaining variables.

Table S3-B-2. Multi-Variable Regression Analysis of Lung Function and ACQ6 by Sex Hormone Levels in Females 6–18 Years with Asthma and BMI <85 percentile (n=12)
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Pre-BD FEV₁ (%)	Estradiol	-0.479	0.12	0.2247	0.12
Post-BD FEV₁ (%)	Estradiol	-0.4184	0.134	0.209	0.135
Pre-BD FVC (%)	Estradiol	-0.291	0.276	0.117	0.276
Post-BD FVC (%)	Estradiol	-0.151	0.555	0.036	0.555
ACQ6	log (DHEA-S)	0.388	0.124	0.220	0.388

*Results reflect final results of a model that started with log (DHEA-S), estradiol, progesterone, and free testosterone as covariates. Covariates that were not significantly associated with the outcome in this model were then removed by backward selection and model was re-run with remaining variables.

Table S4. Univariable Regression Analysis of ACQ6 by Age in children 6–18 Years with Asthma
Outcome variable	Covariate remaining in the model*	Beta coefficient	Covariate p value	R squared	P value of the model
Girls
ACQ6	Age	0.055	0.447	0.025	0.447
ACQ6	Age <12 vs. Age >12 (assuming age 12 defines puberty)	0.397	0.394	0.032	0.394
ACQ6	Are you still menstruating (yes vs. No)	0.939	0.031	0.186	0.031
Boys
ACQ6	Age	-0.09	0.099	0.061	0.099

Authors and Disclosures

Mark D. DeBoer¹, Brenda R. Phillips², David T. Mauger², Joe Zein³, Serpil C. Erzurum³, Anne M. Fitzpatrick⁴, Benjamin M. Gaston⁵, Ross Myers⁵, Kristie R. Ross⁵, James Chmiel⁵, Min Jie Lee⁴, John V. Fahy⁶, Michael Peters⁶, Ngoc P. Ly⁶, Sally E. Wenzel⁷, Merritt L. Fajt⁷, Fernando Holguin⁷, Wendy C. Moore⁸, Stephen P. Peters⁸, Deborah Meyers⁸, Eugene R. Bleecker⁸, Mario Castro⁹, Andrea M. Coverstone⁹, Leonard B. Bacharier⁹, Nizar N. Jarjour¹⁰, Ronald L. Sorkness¹⁰, Sima Ramratnam¹⁰, Anne-Marie Irani¹¹, Elliot Israel¹², Bruce Levy¹², Wanda Phipatanakul¹², Jonathan M. Gaffin¹² and W. Gerald Teague^1*

¹University of Virginia School of Medicine, Charlottesville, VA 22908, USA. ²Pennsylvania State University School of Medicine, Hershey, USA. ³Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, USA. ⁴Emory University School of Medicine, Atlanta, USA. ⁵Rainbow Babies and Children's Hospital, Cleveland, USA. ⁶San Francisco School of Medicine, University of California, San Francisco, USA. ⁷University of Pittsburgh School of Medicine, Pittsburgh, USA. ⁸Wake Forest University School of Medicine, Winston-Salem, USA. ⁹Washington University School of Medicine, St. Louis, USA. ¹⁰University of Wisconsin School of Medicine, Madison, USA. ¹¹Virginia Commonwealth University School of Medicine, Richmond, USA. ¹²Harvard University School of Medicine, Boston, USA.

*Correspondence
wgt2p@virginia.edu; WGT2P@hscmail.mcc.virginia.edu

Authors' contributions
BMG, MDD, WGT, BRP, ERB, MC, JVF, EI, BL, SCE, NNJ, SEW, and DTM devised the present study and/or the data analysis. BMG, WGT, ERB, MC, JVF, EI, BL, SCE, NNJ, SEW, AMF, RM, KRR, JC, MJL, MP, NPL, MLF, FH, WCM, SPP, DM, AMC, LBB, RLS, SR, AMI, WP and JMG were involved in participant recruitment and/or assessment. BRP performed the statistical analysis. MDD, BMG drafted the preliminary manuscript and WGT drafted the final version. All authors read and approved the final manuscript.

Competing interests
There are no conflicts of interest with the study sponsors (NIH/NHLBI) or any commercial entity in the study design, the collection, analysis, and interpretation of the data, the writing of the report, and the decision to submit the paper for publication. The authors submit they will declare potential conflicts of interests per BMC Pulmonary Medicine publication policies.

Effects of Endogenous Sex Hormones on Lung Function and Symptom Control in Adolescents With Asthma

Conclusions

Comments

Most Popular Articles

About

Membership

Apps

WebMD Network

Editions

Effects of Endogenous Sex Hormones on Lung Function and Symptom Control in Adolescents With Asthma

Conclusions

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

Tables

References

Authors and Disclosures

Authors and Disclosures

Comments

Most Popular Articles

Email This

Feedback

Find Us On

About

Membership

Apps

WebMD Network

Editions