Kim Ji Hyoun, Im Yo Han, Noh Ji Hyun, Yuk Jin-Sung
Department of Internal Medicine, Chungbuk National University, Cheongju, Republic of Korea.
Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
Semin Arthritis Rheum. 2025 Apr;71:152632. doi: 10.1016/j.semarthrit.2025.152632. Epub 2025 Jan 30.
This retrospective cohort study aimed to investigate the influence of menopausal hormone therapy (MHT) on the occurrence of systemic lupus erythematosus (SLE) in postmenopausal women. Additionally, the study aimed to examine the specific effects of individual MHT drugs.
In this population-based cohort study conducted in Korea, a total of 452,124 women aged >40 years seeking healthcare for menopause were assessed from January 1, 2011, to December 31, 2014. After employing propensity score matching, 139,331 pairs were included in the MHT and non-MHT groups. Follow-up of participants continued until December 31, 2020. The diagnosis of SLE was based on the International Classification of Diseases 10th edition criteria.
The median follow-up in the study was 7.9 [6.9-8.9] years. SLE developed in 134 (0.1 %) of the 139,197 participants in the MHT group and 143 (0.1 %) of the 139,188 of the non-MHT group, individually. The risk of SLE in the MHT group did not show a significant increase compared to the non-MHT group {hazard ratio (HR) 1.114, 95 % confidence interval (CI) 0.88-1.41}. Subgroup analysis results indicated no significant differences based on the type of MHT or the duration of MHT use, except tibolone. In the group that used tibolone within 3 years, the HR for SLE risk was 1.45 (95 % confidence interval: 1.051-2.001).
The utilization of MHT did not demonstrate a substantial impact on the development of SLE in postmenopausal women. Caution is required in the early stages of tibolone use.
这项回顾性队列研究旨在调查绝经后激素治疗（MHT）对绝经后女性系统性红斑狼疮（SLE）发病的影响。此外，该研究旨在检验个别MHT药物的具体效果。
在韩国进行的这项基于人群的队列研究中，从2011年1月1日至2014年12月31日，对452,124名年龄大于40岁寻求绝经保健的女性进行了评估。采用倾向得分匹配后，MHT组和非MHT组纳入了139,331对。对参与者的随访持续到2020年12月31日。SLE的诊断基于《国际疾病分类》第10版标准。
该研究的中位随访时间为7.9[6.9 - 8.9]年。MHT组的139,197名参与者中有134人（0.1%）发生SLE，非MHT组的139,188名参与者中有143人（0.1%）发生SLE。与非MHT组相比，MHT组SLE的风险没有显著增加{风险比（HR）1.114，95%置信区间（CI）0.88 - 1.41}。亚组分析结果表明，除替勃龙外，基于MHT类型或MHT使用持续时间没有显著差异。在3年内使用替勃龙的组中，SLE风险的HR为1.45（95%置信区间：1.051 - 2.001）。
MHT的使用对绝经后女性SLE的发生没有显著影响。在使用替勃龙早期需要谨慎。
