Type of Menopause, Age at Menopause, and Risk of Developing Obstructive Sleep Apnea in Postmenopausal Women
Type of Menopause, Age at Menopause, and Risk of Developing Obstructive Sleep Apnea in Postmenopausal Women
复制标题
DOI：
10.1093/aje/kwy011
复制
发表时间：
2018-07-01
影响因子：
5
通讯作者：
Tworoger, Shelley S.
中科院分区：
文献类型：
--
作者：
Huang, Tianyi;Lin, Brian M.;Tworoger, Shelley S.
尽管建立了性别差异和性激素影响阻塞性睡眠呼吸暂停（OSA）的病因学的长期假设，我们还没有发现任何研究，评估绝经类型和绝经年龄，影响绝经后激素环境，与OSA的风险在妇女。我们随访了2002-2012年护士健康研究中的50，473名绝经后妇女和1995-2013年护士健康研究II中的53，827名绝经后妇女，分别有1，712和2，560例OSA诊断。与自然绝经相比，通过子宫切除术/卵巢切除术进行手术绝经的OSA合并风险比为1.27（95%置信区间（CI）：1.17，1.38）。在进一步考虑绝经年龄后，这种相关性保持不变（风险比= 1.26，95%CI：1.15，1.38）。非肥胖妇女和从未使用激素治疗的妇女中，与手术绝经相关的风险更高（交互作用P < 0.05）。在调整绝经类型之前，绝经早期与OSA风险较高相关（将年龄< 40岁的患者与年龄50-54岁的患者进行比较，风险比= 1.21，95% CI：1.08，1.35;趋势P = 0.008），尽管调整后未观察到相关性。与自然绝经相比，手术与绝经后妇女OSA风险增高独立相关。我们的研究结果为性激素，特别是突然的激素变化在调节OSA风险中的作用提供了额外的证据。
Despite established sex differences and longstanding hypotheses of sex hormone influence in the etiology of obstructive sleep apnea (OSA), we have found no studies that evaluated type of menopause and age at menopause, which affect postmenopausal hormonal milieu, in relation to OSA risk in women. We followed 50,473 postmenopausal women from the Nurses' Health Study during 2002-2012 and 53,827 postmenopausal women from the Nurses' Health Study II during 1995-2013, with 1,712 and 2,560 incident OSA diagnoses, respectively. Compared with natural menopause, the pooled hazard ratio for OSA was 1.27 (95% confidence interval (CI): 1.17, 1.38) for surgical menopause by hysterectomy/oophorectomy. The association remained the same after further accounting for age at menopause (hazard ratio = 1.26, 95% CI: 1.15, 1.38). The risk associated with surgical menopause was higher among women who were not obese as well as among women who never used hormone therapy (P for interaction < 0.05). Earlier menopause was associated with higher OSA risk prior to adjustment for type of menopause (comparing those aged < 40 years versus those aged 50-54 years, hazard ratio = 1.21, 95% CI: 1.08, 1.35; P for trend = 0.008), although no association was observed after the adjustment. Surgical as compared with natural menopause was independently associated with higher OSA risk in postmenopausal women. Our results provide additional evidence for a role for sex hormones, particularly abrupt hormonal changes, in modulating OSA risk.