Departments of Epidemiology and Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Menopause. 2021 Apr 5;28(7):811-818. doi: 10.1097/GME.0000000000001779.
Whether hormonal changes during menopausal transition postmenopause stages influence pulmonary function is not clearly understood. We evaluated the association between each stage of menopause and the prevalence of abnormal lung function in healthy middle-aged women. We hypothesized that the prevalence of abnormal lung function would increase from the late menopausal transition stage during menopausal transition postmenopause stages.
The study population included women 40 to 65 years of age who underwent comprehensive health screening examination at the Kangbuk Samsung Hospital Total Healthcare Centers from January 2015 to December 2017. Stages of menopause (premenopausal, early menopausal transition, late menopausal transition, and postmenopausal) were defined using the 2011 Stages of Reproductive Aging Workshop (STRAW + 10) criteria. Abnormal lung function was defined based on spirometry as forced expiratory volume in 1 second/forced vital capacity less than70% or forced vital capacity less than 80% predicted. Prevalence ratios (PRs) for abnormal lung function by stages of menopause were estimated from logistic regression models adjusted for age, anthropometric measurements, lifestyle factors, medical history, lipid and inflammatory biomarkers, and reproductive factors.
Among 43,822 participants, there were 4,615 participants (10.5%) with restrictive ventilatory disorder and 653 participants (1.5%) with obstructive ventilatory disorder. The fully adjusted PRs (95% confidence interval) for abnormal ventilatory disorder comparing early menopausal transition, late menopausal transition, and postmenopausal stage to premenopausal stage were 1.01 (0.94-1.08), 1.13 (1.03-1.22), and 1.10 (0.98-1.22), respectively. The fully adjusted PRs for restrictive ventilatory disorder comparing early menopausal transition, late menopausal transition, and postmenopausal stages to premenopausal stage were 1.02 (0.94-1.11), 1.18 (1.06-1.30), and 1.15 (1.00-1.31), respectively. There was, however, no clear association between stages of menopause and obstructive ventilatory disorder.
In this large study of middle-aged women, the fully adjusted prevalence of abnormal lung function, particularly that of restrictive ventilatory disorder, was higher in women in late menopausal transition and menopausal stages compared to women in premenopausal stage.
围绝经期和绝经后阶段的激素变化是否会影响肺功能尚不清楚。我们评估了每个绝经阶段与健康中年女性异常肺功能发生率之间的关系。我们假设,异常肺功能的发生率将从围绝经期过渡阶段的晚期开始增加。
该研究人群包括 2015 年 1 月至 2017 年 12 月在康伯斯三星医院综合保健中心接受全面健康筛查的 40 至 65 岁女性。使用 2011 年生殖衰老研讨会(STRAW+10)标准定义绝经阶段(绝经前、早期绝经过渡、晚期绝经过渡和绝经后)。异常肺功能根据肺活量测定法定义为 1 秒用力呼气量/用力肺活量小于 70%或用力肺活量小于预测值的 80%。使用 logistic 回归模型调整年龄、人体测量测量值、生活方式因素、病史、血脂和炎症生物标志物以及生殖因素后,估计了由绝经阶段的异常肺功能的患病率比(PR)。
在 43822 名参与者中,有 4615 名(10.5%)患有限制性通气障碍,653 名(1.5%)患有阻塞性通气障碍。与绝经前阶段相比,早期绝经过渡、晚期绝经过渡和绝经后阶段的异常通气障碍的完全调整后 PR(95%置信区间)分别为 1.01(0.94-1.08)、1.13(1.03-1.22)和 1.10(0.98-1.22)。与绝经前阶段相比,早期绝经过渡、晚期绝经过渡和绝经后阶段的限制性通气障碍的完全调整后 PR 分别为 1.02(0.94-1.11)、1.18(1.06-1.30)和 1.15(1.00-1.31)。然而,绝经阶段与阻塞性通气障碍之间没有明确的关联。
在这项对中年女性的大型研究中,与绝经前阶段的女性相比,晚期绝经过渡和绝经后阶段的女性异常肺功能,尤其是限制性通气障碍的完全调整后患病率更高。