Prospective study of postmenopausal hormone use and newly diagnosed asthma and chronic obstructive pulmonary disease
Prospective study of postmenopausal hormone use and newly diagnosed asthma and chronic obstructive pulmonary disease
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DOI：
10.1001/archinte.164.4.379
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发表时间：
2004-02-23
影响因子：
--
通讯作者：
Camargo, CA
中科院分区：
文献类型：
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作者：
Barr, RG;Wentowski, CC;Camargo, CA
背景资料：女性生殖激素似乎影响哮喘，虽然数据是相互矛盾的，并可能调节慢性阻塞性肺疾病（COPD）的发展。因此，在一项前瞻性队列研究中，我们评估了绝经后激素的使用是否与新诊断的哮喘和新诊断的COPD.Methods的发病率增加有关：从1976年起，每两年通过问卷调查评估绝经后激素的使用。1988年至1996年，哮喘或COPD的新医生诊断通过问卷进行报告，并在1998年使用补充问卷进行确认。等级的诊断确定性建立从报告的药物使用和肺功能使用验证definition.Results：在546 259人年的后续行动，目前使用的雌激素单独与哮喘的发病率增加（多变量率比，2.29; 95%置信区间[CI]，1.59-3.29）相比，那些从未使用激素。目前使用雌激素加雷公藤多甙的患者新诊断哮喘的比例也有类似的增加。率比随着哮喘诊断的确定性而增加。相比之下，新诊断的COPD率是相同的激素使用者和非用户（多变量率比，1.05; 95%CI，0.80-1.37）。结论：绝经后激素的使用与新诊断的哮喘，但新诊断的COPD的发病率增加。女性生殖激素可能导致成年女性哮喘的发作，但似乎不会加速COPD的发展。
Background: Female reproductive hormones appear to influence asthma, although data are conflicting, and may modulate development of chronic obstructive pulmonary disease (COPD). Therefore, in a prospective cohort study, we evaluated whether postmenopausal hormone use was associated with an increased rate of newly diagnosed asthma and, separately, newly diagnosed COPD.Methods: Postmenopausal hormone use was assessed by questionnaire biennially from 1976 onward. New physician diagnoses of asthma or COPD were reported on questionnaires from 1988 to 1996 and confirmed in 1998 using supplementary questionnaires. Grades of diagnostic certainty were established from reports of medication use and pulmonary function using validated definitions.Results: During 546 259 person-years of follow-up, current use of estrogen alone was associated with an increased rate of asthma (multivariate rate ratio, 2.29; 95% confidence interval [CI], 1.59-3.29) compared with those who never used hormones. Current users of estrogen plus progestin had a similarly increased rate of newly diagnosed asthma. Rate ratios increased with certainty of diagnosis of asthma. In contrast, rates of newly diagnosed COPD were the same among hormone users and non-users (multivariate rate ratio, 1.05; 95% Cl, 0.80-1.37).Conclusions: Postmenopausal hormone use was associated with an increased rate of newly diagnosed asthma but not newly diagnosed COPD. Female reproductive hormones may contribute to the onset of asthma among adult women, but do not appear to hasten the development of COPD.