Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
J Allergy Clin Immunol. 2016 Jan;137(1):50-57.e6. doi: 10.1016/j.jaci.2015.08.019. Epub 2015 Oct 2.
There is limited and conflicting evidence on the effect of menopause on asthma.
We sought to study whether the incidence of asthma and respiratory symptoms differ by menopausal status in a longitudinal population-based study with an average follow-up of 12 years.
The Respiratory Health in Northern Europe study provided questionnaire data pertaining to respiratory and reproductive health at baseline (1999-2001) and follow-up (2010-2012). The study cohort included women aged 45 to 65 years at follow-up, without asthma at baseline, and not using exogenous hormones (n = 2322). Menopausal status was defined as nonmenopausal, transitional, early postmenopausal, and late postmenopausal. Associations with asthma (defined by the use of asthma medication, having asthma attacks, or both) and respiratory symptoms scores were analyzed by using logistic (asthma) and negative binomial (respiratory symptoms) regressions, adjusting for age, body mass index, physical activity, smoking, education, and study center.
The odds of new-onset asthma were increased in women who were transitional (odds ratio, 2.40; 95% CI, 1.09-5.30), early postmenopausal (odds ratio, 2.11; 95% CI, 1.06-4.20), and late postmenopausal (odds ratio, 3.44; 95% CI, 1.31-9.05) at follow-up compared with nonmenopausal women. The risk of respiratory symptoms increased in early postmenopausal (coefficient, 0.40; 95% CI, 0.06-0.75) and late postmenopausal (coefficient, 0.69; 95% CI, 0.15-1.23) women. These findings were consistent irrespective of smoking status and across study centers.
New-onset asthma and respiratory symptoms increased in women becoming postmenopausal in a longitudinal population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging.
关于更年期对哮喘的影响，现有证据有限且相互矛盾。
我们旨在通过一项平均随访时间为 12 年的纵向人群研究，研究更年期状态对哮喘和呼吸道症状的影响。
北欧呼吸健康研究提供了基线（1999-2001 年）和随访（2010-2012 年）时与呼吸道和生殖健康相关的调查问卷数据。研究队列包括随访时年龄在 45 至 65 岁、基线时无哮喘且未使用外源性激素的女性（n=2322）。更年期状态定义为非更年期、过渡期、早期绝经后和晚期绝经后。采用逻辑回归（哮喘）和负二项回归（呼吸道症状）分析与哮喘（通过使用哮喘药物、哮喘发作或两者兼用来定义）和呼吸道症状评分相关的关联，调整因素包括年龄、体重指数、身体活动、吸烟、教育程度和研究中心。
与非更年期女性相比，处于过渡期（比值比，2.40；95%置信区间，1.09-5.30）、早期绝经后（比值比，2.11；95%置信区间，1.06-4.20）和晚期绝经后（比值比，3.44；95%置信区间，1.31-9.05）的女性新患哮喘的几率增加。早期绝经后（系数，0.40；95%置信区间，0.06-0.75）和晚期绝经后（系数，0.69；95%置信区间，0.15-1.23）女性的呼吸道症状风险增加。这些发现无论吸烟状况如何以及在各研究中心均一致。
在一项纵向人群研究中，女性绝经后新患哮喘和呼吸道症状的风险增加。临床医生应意识到，女性在生殖衰老过程中呼吸健康可能会恶化。
