UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, Inserm, Paris, France; Faculty of Medicine, Univ Paris-Sud, Le Kremlin-Bicêtre, France.
UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Epidemiology Team, Inserm, Paris, France; UMR 1152, Univ Paris Diderot Paris7, Paris, France.
Maturitas. 2018 Dec;118:44-50. doi: 10.1016/j.maturitas.2018.10.006. Epub 2018 Oct 24.
The gender switch in asthma incidence around puberty has been put forward to suggest a role of sex hormones in asthma. However, there are limited and inconsistent findings on change in asthma incidence with menopause. We aimed to investigate the associations between menopause and asthma incidence, and interactions with overweight/obesity.
Asthma incidence was assessed in 67,872 women free of asthma at baseline (aged 41-68 years) and regularly followed up as a part of the French E3N cohort. Adjusted hazard ratios (aHR) were derived from Cox models considering age as the time-scale, menopausal status as a time-varying covariate and taking into account menopausal treatment.
During 843,243 person-years of follow-up, 1205 new-onset asthma cases were identified. Compared with pre-menopause, surgical menopause was associated with an increased risk of asthma onset (aHR = 1.33 [95%CI 1.01-1.75]) but no association was observed for natural menopause (aHR = 1.05 [0.84-1.32]). In women with natural menopause, a further analysis separating the transition through menopause and the later post-menopausal period did not show any change in asthma incidence with menopause in the total sample or in normal-weight women alone. However, in overweight/obese women, peri-menopausal and post-menopausal women had an increased risk of developing asthma compared with pre-menopausal women of the same age (aHR = 1.91 [1.00-3.66] and aHR = 2.08 [1.07-4.06] respectively).
Surgical menopause was associated with an increased risk of asthma onset. For natural menopause, no change in asthma incidence was observed in normal-weight women. However, overweight/obese women had an increased risk of developing asthma after natural menopause.
青春期前后哮喘发病率的性别转换提示性激素在哮喘发病中起作用。然而，关于绝经后哮喘发病率变化的研究结果有限且不一致。本研究旨在探讨绝经与哮喘发病的关系，并探讨其与超重/肥胖的交互作用。
在法国 E3N 队列中，我们对 67872 名基线时无哮喘（年龄 41-68 岁）且定期随访的女性进行了哮喘发病率评估。使用 Cox 模型，以年龄为时间尺度，将绝经状态作为时变协变量，同时考虑绝经治疗，得出调整后的风险比（aHR）。
在 843243 人年的随访期间，共确诊 1205 例新发哮喘病例。与绝经前相比，手术绝经与哮喘发病风险增加相关（aHR=1.33 [95%CI 1.01-1.75]），而自然绝经与哮喘发病风险无关（aHR=1.05 [0.84-1.32]）。在自然绝经的女性中，进一步分析绝经过渡和后期绝经后时期，并未发现整个样本或单纯正常体重女性的哮喘发病率随绝经而发生变化。然而，在超重/肥胖女性中，围绝经期和绝经后女性与同年龄的绝经前女性相比，哮喘发病风险增加（aHR=1.91 [1.00-3.66] 和 aHR=2.08 [1.07-4.06]）。
手术绝经与哮喘发病风险增加相关。对于自然绝经，正常体重女性的哮喘发病率无变化。然而，超重/肥胖女性在自然绝经后哮喘发病风险增加。
