Moll Matthew, Regan Elizabeth A, Hokanson John E, Lutz Sharon M, Silverman Edwin K, Crapo James D, Make Barry J, DeMeo Dawn L
Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Chronic Obstr Pulm Dis. 2020 Apr;7(2):86-98. doi: 10.15326/jcopdf.7.2.2019.0166.
Apparent increased female susceptibility to chronic obstructive pulmonary disease (COPD) suggests sex hormones modulate disease pathogenesis. Little is known about associations between multiparity and lung function in smokers.
We hypothesized that multiparity is associated with lung function and measures of emphysema and airway disease.
Utilizing female participants from the 5-year follow up of the COPD Genetic Epidemiology (COPDGene) study we performed multivariable linear regressions to assess the effect of multiparity and number of pregnancies on forced expiratory volume in 1 second (FEV) percentage of predicted (% predicted), FEV/forced vital capacity (FVC), percent emphysema on computed tomography (CT) scans, and Pi10, a measure of airway thickening. We sampled never smokers and those with lower smoking exposure from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 dataset.
We included 1820 participants from COPDGene and 418 participants from NHANES (321 never smokers, 97 ever smokers). In COPDGene, multiparity (beta coefficient [β] = -3.8, 95% confidence interval [CI]: [-6.5, -1.1], = 0.005) and higher number of pregnancies were associated with lower FEV % predicted. Multiparity was not associated with percent emphysema or Pi10. In individuals with no or mild obstruction, multiparity was associated with lower FEV % predicted. There was an interaction with multiparity and age on FEV % predicted ( = 0.025). In NHANES, there was no association between multiparity and FEV % predicted in never smokers or the lower smoking exposure group.
Multiparity was associated with lower FEV % predicted in current and former smokers in COPDGene study participants. These preliminary results emphasize the importance of smoking abstinence in women of child-bearing age.
女性对慢性阻塞性肺疾病（COPD）的易感性明显增加，这表明性激素会调节疾病的发病机制。关于多产与吸烟者肺功能之间的关联，我们知之甚少。
我们假设多产与肺功能以及肺气肿和气道疾病的指标相关。
利用慢性阻塞性肺疾病遗传流行病学（COPDGene）研究5年随访中的女性参与者，我们进行了多变量线性回归，以评估多产和妊娠次数对1秒用力呼气量（FEV）占预计值百分比（%预计值）、FEV/用力肺活量（FVC）、计算机断层扫描（CT）上的肺气肿百分比以及气道增厚指标Pi10的影响。我们从2011 - 2012年美国国家健康与营养检查调查（NHANES）数据集中抽取了从不吸烟者和吸烟暴露较低者作为样本。
我们纳入了1820名来自COPDGene研究的参与者和418名来自NHANES的参与者（321名从不吸烟者，97名曾经吸烟者）。在COPDGene研究中，多产（β系数[β] = -3.8，95%置信区间[CI]：[-6.5, -1.1]，P = 0.005）和较高的妊娠次数与较低的FEV %预计值相关。多产与肺气肿百分比或Pi10无关。在无阻塞或轻度阻塞的个体中，多产与较低的FEV %预计值相关。在FEV %预计值方面，多产与年龄存在交互作用（P = 0.025）。在NHANES研究中，从不吸烟者或吸烟暴露较低组中，多产与FEV %预计值之间无关联。
在COPDGene研究参与者中，多产与当前和既往吸烟者较低的FEV %预计值相关。这些初步结果强调了育龄女性戒烟的重要性。
