National Instituto of Public Health, Cuernavaca, Mexico 2INSERM, ER120/Université Paris-Sud, Faculté de Médicine, IFR69/Institut Gustave Roussy, Villejuif, France.
Thorax. 2010 Apr;65(4):292-7. doi: 10.1136/thx.2009.116079. Epub 2010 Feb 8.
Epidemiological studies have suggested that female hormones might play a role in asthma and that menopausal hormone therapy (MHT or hormone replacement therapy (HRT)) might increase the risk of asthma in postmenopausal women. The only prospective study addressing this issue reports an increase in the risk of developing asthma which was similar for oestrogen alone and oestrogen/progestagen treatment.
The association between the use of different types of MHT and the risk of asthma onset in postmenopausal women was investigated prospectively from 1990 to 2002 by biennial questionnaires as part of the French E3N cohort study. Asthma onset was considered to be the time of medical diagnosis of asthma cases occurring during the follow-up of women who were asthma free at baseline. Cox proportional hazards models were used, adjusting for potential confounding factors.
Among 57 664 women free of asthma at menopause, 569 incident cases of asthma were identified during 495 448 years of follow-up. MHT was related to an increased risk of asthma onset (HR=1.20, 95% CI 0.98 to 1.46) among recent users. The increase in risk of asthma onset was only significant among women reporting the use of oestrogen alone (HR=1.54, 95% CI 1.13 to 2.09) particularly in never smokers (HR=1.80, 95% CI 1.15 to 2.80) and women reporting allergic disease prior to asthma onset (HR=1.86, 95% CI 1.18 to 2.93). A small increase in the risk of asthma onset associated with the use of oestrogen/progestagen was also observed in these subgroups.
Postmenopausal use of oestrogen alone was associated with an increased rate of newly diagnosed asthma in menopausal women.
流行病学研究表明，女性激素可能在哮喘中起作用，绝经后激素治疗（MHT 或激素替代疗法（HRT））可能增加绝经后妇女患哮喘的风险。唯一一项针对该问题的前瞻性研究报告称，雌激素单独治疗和雌激素/孕激素联合治疗的哮喘发病风险增加相似。
1990 年至 2002 年，通过每两年进行一次问卷调查，作为法国 E3N 队列研究的一部分，前瞻性研究不同类型 MHT 与绝经后妇女哮喘发病风险之间的关系。哮喘发病被认为是在基线时无哮喘的女性随访期间发生哮喘病例的时间。使用 Cox 比例风险模型，调整了潜在的混杂因素。
在无绝经后哮喘的 57664 名女性中，在 495448 年的随访期间，发现 569 例哮喘新发病例。MHT 与近期使用者哮喘发病风险增加相关（HR=1.20，95%CI 0.98-1.46）。仅在报告使用雌激素单独治疗的女性中，哮喘发病风险增加具有统计学意义（HR=1.54，95%CI 1.13-2.09），特别是在从不吸烟的女性中（HR=1.80，95%CI 1.15-2.80）和在哮喘发病前报告有过敏疾病的女性中（HR=1.86，95%CI 1.18-2.93）。在这些亚组中，也观察到使用雌激素/孕激素与哮喘发病风险略有增加相关。
绝经后单独使用雌激素与绝经后妇女新诊断哮喘的发生率增加有关。
