Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
Chest. 2021 Jul;160(1):45-52. doi: 10.1016/j.chest.2021.01.054. Epub 2021 Mar 26.
Hormone replacement therapy (HRT) is prescribed to millions of women worldwide. Previous studies have suggested that HRT has both protective and harmful effects in asthma.
Is HRT in menopause associated with new development of asthma?
We undertook a nested case-control study based on the Danish registers from June 1, 1995, through December 31, 2018. A diagnosis of asthma was defined as two redeemed prescriptions of inhaled corticosteroids within 2 years. HRT was defined as two redeemed prescriptions of female sex hormones within 6 months. Data were analyzed using a conditional logistic regression model.
We included 34,533 women with asthma vs 345,116 women without asthma between 40 and 65 years of age. In a multivariate analysis adjusted for age, household income, and educational level, active HRT resulted in a hazard ratio (HR) of 1.63 (95% CI, 1.55-1.71; P < .001) of new asthma development. Women with asthma who terminated HRT were likely to discontinue their asthma treatment subsequently (HR, 2.12; 95% CI, 1.94-2.33; P < .001).
HRT seems to play a role in the development of asthma in mature women. Clinicians prescribing HRT and women receiving HRT should be aware that new airway symptoms can develop, and discontinuation of HRT should be considered.
全球有数百万女性接受激素替代疗法（HRT）。先前的研究表明，HRT 对哮喘既有保护作用，也有有害作用。
更年期 HRT 是否与新发生的哮喘有关？
我们基于丹麦登记系统，进行了一项嵌套病例对照研究，时间范围为 1995 年 6 月 1 日至 2018 年 12 月 31 日。哮喘的诊断定义为在 2 年内两次开具吸入皮质类固醇的处方。HRT 定义为在 6 个月内两次开具女性性激素的处方。数据分析采用条件逻辑回归模型。
我们纳入了 34533 名年龄在 40 至 65 岁之间的哮喘患者和 345116 名无哮喘患者。在调整年龄、家庭收入和教育水平的多变量分析中，使用 HRT 与新哮喘发展的风险比（HR）为 1.63（95%CI，1.55-1.71；P<0.001）。终止 HRT 的哮喘患者随后更有可能停止哮喘治疗（HR，2.12；95%CI，1.94-2.33；P<0.001）。
HRT 似乎在成熟女性哮喘的发展中起作用。开具 HRT 处方的临床医生和接受 HRT 的女性应意识到可能会出现新的气道症状，应考虑停止 HRT。
