Sahyoun N R, Brett K M, Hochberg M C, Pamuk E R
National Center for Health Statistics, Hyattsville, Maryland 20782, USA.
Prev Med. 1999 May;28(5):458-64. doi: 10.1006/pmed.1998.0440.
This longitudinal study examined the association between use of estrogen replacement therapy and incidence of self-reported, physician-diagnosed arthritis.
Data of 2,416 postmenopausal women who participated in the National Health and Nutrition Examination Survey Epidemiological Follow-Up Study were used in this study. Women, free of self-reported arthritis at entry into study and for 3 years thereafter, were questioned about use of estrogen and physician-diagnosed arthritis at each of the follow-up waves of study. Proportional hazard regression models were used for the analysis.
Use of ERT was found to be associated with higher risk of incident arthritis, after adjusting for potential confounders (RR = 1.61, CI 1.37-1.89). Whenever use of ERT was replaced by duration of use in the regression model, ERT users for a year or less significantly increased their risk of incident arthritis (RR = 1.37, CI 1.07-1.74). The risk increased by 30 and 96% with hormone use for 1 to 4 and 4 to 10 years, respectively, and by 104% with hormone use for 10 or more years.
Results suggest that users of ERT were at higher risk of developing arthritis and the longer the use of the hormone, the higher the risk.
这项纵向研究调查了雌激素替代疗法的使用与自我报告、医生诊断的关节炎发病率之间的关联。
本研究使用了参加美国国家健康与营养检查调查流行病学随访研究的2416名绝经后女性的数据。在研究开始时及之后3年内无自我报告关节炎的女性，在每次随访时被询问雌激素使用情况和医生诊断的关节炎情况。采用比例风险回归模型进行分析。
在调整潜在混杂因素后，发现使用雌激素替代疗法与关节炎发病风险较高相关（风险比=1.61，可信区间1.37 - 1.89）。在回归模型中，每当将雌激素替代疗法的使用替换为使用时长时，使用一年或更短时间的雌激素替代疗法使用者患关节炎的风险显著增加（风险比=1.37，可信区间1.07 - 1.74）。使用激素1至4年和4至10年时，风险分别增加30%和96%，使用激素10年或更长时间时，风险增加104%。
结果表明，雌激素替代疗法使用者患关节炎的风险较高，且激素使用时间越长，风险越高。
