Postmenopausal hormone therapy and Alzheimer disease: A prospective cohort study.
Postmenopausal hormone therapy and Alzheimer disease: A prospective cohort study.
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DOI：
10.1212/wnl.0000000000003696
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发表时间：
2017-03-14
期刊：
影响因子：
9.9
通讯作者：
Tolppanen AM
中科院分区：
文献类型：
--
作者：
Imtiaz B;Tuppurainen M;Rikkonen T;Kivipelto M;Soininen H;Kröger H;Tolppanen AM
探讨绝经后激素治疗（HT）与阿尔茨海默病（AD）之间的关联。使用了库奥皮奥骨质疏松症危险因素和预防研究队列的二十年随访数据。自 1989 年起至 2009 年，每五年向居住在库奥皮奥省的所有 47 至 56 岁的女性发送自填问卷。自 1995 年以来，就提供了基于登记册的 HT 处方信息。根据 DSM-IV 和国家神经和交流障碍研究所以及中风 - 阿尔茨海默氏病和相关疾病协会标准，从特别报销登记册（1999-2009 年）中确定了可能的 AD 病例。研究人群包括 8,195 名女性（227 例 AD 病例）。在基于登记或自我报告的数据中，绝经后雌激素的使用与 AD 风险无关（风险比/95% 置信区间分别为 0.92/0.68–1.2、0.99/0.75–1.3）。长期自我报告的绝经后 HT 与 AD 风险降低相关 (0.53/0.31–0.91)。出院登记册中任何痴呆症诊断结果都获得了类似的结果。我们的研究结果并没有为绝经后使用 HT 与 AD 或痴呆之间的保护性关联提供强有力的证据，尽管我们观察到长期自我报告使用 HT 的患者 AD 风险降低。
To explore the association between postmenopausal hormone therapy (HT) and Alzheimer disease (AD). Twenty-year follow-up data from the Kuopio Osteoporosis Risk Factor and Prevention study cohort were used. Self-administered questionnaires were sent to all women aged 47–56 years, residing in Kuopio Province starting in 1989 until 2009, every 5th year. Register-based information on HT prescriptions was available since 1995. Probable AD cases, based on DSM-IV and National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association criteria, were identified from the special reimbursement register (1999–2009). The study population included 8,195 women (227 cases of incident AD). Postmenopausal estrogen use was not associated with AD risk in register-based or self-reported data (hazard ratio/95% confidence interval 0.92/0.68–1.2, 0.99/0.75–1.3, respectively). Long-term self-reported postmenopausal HT was associated with reduced AD risk (0.53/0.31–0.91). Similar results were obtained with any dementia diagnosis in the hospital discharge register as an outcome. Our results do not provide strong evidence for a protective association between postmenopausal HT use and AD or dementia, although we observed a reduced AD risk among those with long-term self-reported HT use.