Menopause, postmenopausal hormone use and risk of incident gout.
Menopause, postmenopausal hormone use and risk of incident gout.
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DOI：
10.1136/ard.2009.109884
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发表时间：
2010-07
影响因子：
27.4
通讯作者：
Choi HK
中科院分区：
文献类型：
--
作者：
Hak AE;Curhan GC;Grodstein F;Choi HK
前瞻性研究绝经、绝经后激素使用与痛风风险之间的关系，因为女性性激素已被假定可降低女性痛风风险。在护士健康研究中，我们在92,535名基线时没有痛风的妇女中研究了绝经、绝经年龄、绝经后激素使用和自我报告的医生诊断的痛风事件风险之间的关系。我们使用多变量比例风险回归分析来调整痛风的其他危险因素，如年龄、体重指数、利尿剂使用、高血压、酒精摄入和饮食因素。在16年的随访（1，240，231人年）中，我们记录了1，703例痛风事件。痛风的发病率从<45岁女性的0.6/1000人-年增加到≥75岁女性的2.5/1000人-年（趋势p <0.001）。与绝经前女性相比，绝经后女性痛风发生的风险更高（多变量校正的相对风险[RR]，1.26; 95%置信区间[CI]，1.03 - 1.55）。在自然绝经的妇女中，绝经年龄<45岁的妇女与绝经年龄50 - 54岁的妇女相比，痛风的RR为1.62（95%CI，1.12 - 2.33）。绝经后激素使用者痛风风险降低（RR，0.82; 95%CI，0.70 - 0.96）。这些前瞻性研究结果表明，绝经增加痛风的风险，而绝经后激素治疗适度降低痛风的风险。
To prospectively study the relation between menopause, postmenopausal hormone use and risk of gout, since female sex hormones have been postulated to decrease gout risk among women. In the Nurses’ Health Study, we examined the association between menopause, age at menopause, postmenopausal hormone use and risk of self-reported physician diagnosed incident gout among 92,535 women without gout at baseline. We used multivariate proportional hazards regression analysis to adjust for other risk factors for gout such as age, body mass index, diuretic use, hypertension, alcohol intake and dietary factors. During 16 years of follow-up (1,240,231 person-years), we documented 1,703 incident gout cases. The incidence rate of gout increased from 0.6 per 1000 person-years in women <45 years of age to 2.5 in women ≥75 years of age (p for trend<0.001). Compared with premenopausal women, postmenopausal women had a higher risk of incident gout (multivariate-adjusted relative risk [RR], 1.26; 95% Confidence Interval [CI], 1.03 to 1.55). Among women with natural menopause, women with age at menopause <45 years had a RR of 1.62 (95% CI, 1.12 to 2.33) of gout compared with women with age at menopause 50 to 54 years. Postmenopausal hormone users had a reduced risk of gout (RR, 0.82; 95% CI, 0.70 to 0.96). These prospective findings indicate that menopause increases the risk of gout, whereas postmenopausal hormone therapy modestly reduces gout risk.
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