Association between Estrogen Exposure and Idiopathic Subglottic Stenosis.
Association between Estrogen Exposure and Idiopathic Subglottic Stenosis.
复制标题
雌激素暴露与特发性声门下狭窄之间的关联。
DOI：
10.1002/lary.31030
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
NorthAmericanAirwayCollaborative
中科院分区：
文献类型：
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作者：
Nanda,Nainika;Huang,Li-Ching;Chen,Sheau-Chiann;Berry,LynneD;Talatala,EdwardRyanR;Clark,Evan;Ye,Wenda;Gelbard,Alexander;Francis,DavidO;NorthAmericanAirwayCollaborative
特发性声门下狭窄（iSGS）是一种罕见的，复发性，纤维炎症性疾病，影响喉和近端气管。由于它主要发生在成年女性中，推测雌激素起着重要的病理生理作用。本研究旨在评估雌激素暴露，疾病进展和recurrence.MethodsNorth American Airway Collaborative（NoAAC）数据的成年人iSGS阻塞性气道病变，谁进行指数内镜下气道扩张，用于确定雌激素暴露，疾病特征和复发时间（TTR）之间的关联，干预措施进行了分析，使用Kruskal-Wallis检验和皮尔逊系数。考克斯比例风险回归模型比较了雌激素暴露的风险比。Kaplan-Meier曲线绘制TTR的基础上绝经status.ResultsIn所有，533名女性有完整的雌激素数据（33%绝经前，17%围绝经期，50%绝经后）。中位雌激素暴露时间为28年。总的来说，雌激素暴露和疾病复发之间没有剂量反应关系。绝经前患者从症状出现到诊断的时间明显缩短（绝经前后1.17年vs. 1.42年vs.绝经后2.08年，p< 0.001），从诊断到首次内镜下气道扩张的时间更短（1.90 vs. 2.50 vs. 3.76 years，p= 0.005），以及更高的手术次数（1.73 vs. 1.20 vs. 1.08 procedures，p< 0.001）.然而，目前尚不清楚这是否与绝经期和绝经后状态下雌激素减少有关，或者与年龄相关的伤口愈合和炎症生理学有关，无论雌激素如何。
ObjectiveIdiopathic subglottic stenosis (iSGS) is a rare, recurrent, fibroinflammatory disease affecting the larynx and proximal trachea. Given it occurs primarily in adult females, estrogen is speculated to play a central pathophysiological role. This study aimed to evaluate relationships between estrogen exposure, disease progression, and recurrence.MethodsNorth American Airway Collaborative (NoAAC) data of adults with iSGS obstructive airway lesions, who underwent index endoscopic airway dilation, were used to identify associations between estrogen exposure, disease characteristics, and time to recurrence (TTR), and interventions were analyzed using Kruskal–Wallis test and Pearson coefficient. Cox proportional hazards regression models compared hazard ratios by estrogen exposure. Kaplan–Meier curves were plotted for TTR based on menopausal status.ResultsIn all, 533 females had complete estrogen data (33% premenopausal, 17% perimenopausal, 50% postmenopausal). Median estrogen exposure was 28 years. Overall, there was no dose–response relationship between estrogen exposure and disease recurrence. Premenopausal patients had significantly shorter time from symptom manifestation to diagnosis (1.17 vs. 1.42 years perimenopausal vs. 2.08 years postmenopausal,p< 0.001), shorter time from diagnosis to index endoscopic airway dilation (1.90 vs. 2.50 vs. 3.76 years,p= 0.005), and higher number of procedures (1.73 vs. 1.20 vs. 1.08 procedures,p< 0.001).ConclusionsWe demonstrate premenopausal patients may have a more aggressive disease variant than their peri‐ and postmenopausal counterparts. However, it is unclear as to whether this is related to reduced estrogen in the peri‐ and postmenopausal states or the age‐related physiology of wound healing and inflammation, regardless of estrogen.Level of Evidence3Laryngoscope, 134:825–830, 2024