Liu Ding-Hao, Kuo Chia-Hua, Wang Chia-To, Chiu Ch-Chih, Chen Tzeng-Ji, Hwang De-Kuang, Kao Chung-Lan
Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Front Aging Neurosci. 2017 Dec 12;9:404. doi: 10.3389/fnagi.2017.00404. eCollection 2017.
Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. Numerous investigations have reported an increased BPPV incidence in females and in the aged population. The hormonal characteristics of BPPV patients have not been previously investigated. This study aimed to determine the risk of BPPV in relation to menopause in a population-based study. : This retrospective population-based study was designed to use a nationwide longitudinal health insurance database to follow and analyze the incidence of and protective factors against BPPV in a Taiwanese population. : Univariate and multivariate analyses were performed to calculate the adjusted hazard ratio (aHR) for the incidence of BPPV using Cox-proportional regression models. : In the multivariate analyses, we found that older people (older than 65 years old) were more prone to develop BPPV (aHR: 5.37, 95% CI: 0 4.83-5.97, < 0.001). The risk of BPPV was analyzed in two specific age subgroups of elderly females. Results revealed that in both age groups (45-65 years old and >65 years old), patients who took estrogen for menopausal syndromes had a significantly lower incidence of BPPV (aHR; 0.01, 95% CI: 0.06-0.23, < 0.001). : Our study provides a novel etiology and possible treatment method for the prevention of BPPV. Further studies may focus on the pathophysiological mechanism of estrogen in BPPV patients and the development of new drugs for the prevention and treatment of BPPV.
良性阵发性位置性眩晕（BPPV）是周围性眩晕最常见的病因。大量研究报告称，女性和老年人群中BPPV的发病率有所增加。此前尚未对BPPV患者的激素特征进行研究。本研究旨在通过一项基于人群的研究确定与绝经相关的BPPV风险。：这项基于人群的回顾性研究旨在利用全国范围的纵向健康保险数据库，对台湾人群中BPPV的发病率及其保护因素进行跟踪和分析。：采用单因素和多因素分析，使用Cox比例回归模型计算BPPV发病率的调整风险比（aHR）。：在多因素分析中，我们发现老年人（65岁以上）更容易发生BPPV（aHR：5.37，95%CI：4.83-5.97，<0.001）。我们在老年女性的两个特定年龄亚组中分析了BPPV的风险。结果显示，在两个年龄组（45-65岁和>65岁）中，因绝经综合征服用雌激素的患者BPPV发病率显著较低（aHR；0.01，95%CI：0.06-0.23，<0.001）。：我们的研究为预防BPPV提供了一种新的病因及可能的治疗方法。进一步的研究可聚焦于雌激素在BPPV患者中的病理生理机制以及预防和治疗BPPV的新药研发。
