Koepsell T D, Dugowson C E, Nelson J L, Voigt L F, Daling J R
Department of Epidemiology, University of Washington, Seattle 98195, USA.
Int J Epidemiol. 1994 Dec;23(6):1248-55. doi: 10.1093/ije/23.6.1248.
Several reproductive factors appear to affect a women's risk of developing rheumatoid arthritis. This study's purpose was to determine whether use of non-contraceptive hormones is among them.
A population-based case-control study was conducted in King County, Washington and Group Health Cooperative of Puget Sound, a prepaid health plan. New cases of rheumatoid arthritis in peri- or postmenopausal women (n = 135) were verified through clinical examination and compared with 592 controls. Both groups were interviewed in person about hormone use and demographic and reproductive factors.
The age-adjusted relative risk (RR) among women who had ever used non-contraceptive oestrogens was 1.04 (95% confidence interval [CI]: 0.70-1.55), and among women who had ever used progestins it was 0.66 (95% CI: 0.40-1.08). For current users of oestrogen only, the RR was 0.97 (95% CI: 0.62-1.53), and among current users of oestrogen plus progestin it was 0.81 (95% CI: 0.45-1.45). Multivariate analyses yielded similar results. There was little evidence of a dose-response relationship with duration of use or with frequency of progestin use.
Use of non-contraceptive oestrogens appears to have little effect on the risk of developing rheumatoid arthritis in menopausal women. There may be a modest reduction in risk among progestin users.
多种生殖因素似乎会影响女性患类风湿性关节炎的风险。本研究的目的是确定使用非避孕激素是否属于其中之一。
在华盛顿州金县和普吉特海湾地区健康合作组织(一个预付健康计划)进行了一项基于人群的病例对照研究。通过临床检查核实围绝经期或绝经后女性类风湿性关节炎新病例(n = 135),并与592名对照进行比较。两组均就激素使用情况以及人口统计学和生殖因素接受了面对面访谈。
曾经使用过非避孕雌激素的女性经年龄调整后的相对风险(RR)为1.04(95%置信区间[CI]:0.70 - 1.55),曾经使用过孕激素的女性为0.66(95%CI:0.40 - 1.08)。仅当前使用雌激素的女性,RR为0.97(95%CI:0.62 - 1.53),当前同时使用雌激素加孕激素的女性为0.81(95%CI:0.45 - 1.45)。多变量分析得出了类似结果。几乎没有证据表明存在与使用持续时间或孕激素使用频率的剂量反应关系。
使用非避孕雌激素似乎对绝经后女性患类风湿性关节炎的风险影响不大。孕激素使用者的风险可能会适度降低。