哮喘联盟

   摘要
   背景:更年期对哮喘作用的证据是有限而且相互矛盾的。
   目的:本研究目的是探索哮喘和呼吸道症状发病率是否因绝经期状态而不同，这是一项纵向的基于人群的研究，平均随访时间为12年。
   方法:北欧地区呼吸系统健康研究提供了相关呼吸系统及生殖健康的基线水平（1999-2001）和随访情况（2010-1012）的问卷调查资料。研究的队列包括了随访中年龄在45到65岁之间的女性，基线水平未患哮喘，未额外补充激素（n=2322）。绝经状态定义为非绝经期，过渡期，绝经后早期，绝经后晚期。与哮喘（定义为使用哮喘药物，有哮喘发作，或者二者都有）以及呼吸系统症状评分的相关性采用 logistic回归 （哮喘）和负二项式回归（呼吸系统症状），校正年龄，体质指数，体力活动，吸烟，教育情况和研究中心。
   结果:随访中过渡期（OR值为2.40；95% CI, 1.09-5.30）、绝经后早期(OR= 2.11; 95% CI, 1.06-4.20)、绝经后晚期 (OR=3.44; 95% CI, 1.31-9.05) 的女性新发哮喘的机率较非绝经期女性均有提高。绝经后早期妇女(相关系数 0.40; 95% CI, 0.06-0.75) 和绝经后晚期女性 (相关系数 0.69; 95% CI, 0.15-1.23) 的呼吸系统症状的风险均有提高。这些发现在不同的吸烟状态和不同的研究中心中结果都是一致的。
   结论:在一项基于人群的纵向研究中女性在进入绝经期的过程中新发哮喘和呼吸系统症状会增加。 临床医生应当知道女性在生育衰老中呼吸健康可能会恶化。
 

（杨冬 审校）
JAllergyClinImmunol. 2015Oct1.pii:S0091-6749(15)01243-9.doi:10.1016/j.jaci.2015.08.019. [Epub ahead of print]

 

Menopause as a predictor of new-onset asthma: A longitudinal Northern European population study.
 

Triebner K1, Johannessen A2, Puggini L3, Benediktsdóttir B4, Bertelsen RJ5, Bifulco E6, Dharmage SC7, Dratva J8, Franklin KA9, Gíslason T10, Holm M11, Jarvis D12, Leynaert B13, Lindberg E14, Malinovschi A15, Macsali F16, Norbäck D17, Omenaas ER2, Rodríguez FJ18, Saure E5, Schlünssen V19,Sigsgaard T19, Skorge TD5, Wieslander G17, Zemp E8, Svanes C5, Hustad S6, Gómez Real F20.
 

Abstract
BACKGROUND:There is limited and conflicting evidence on the effect of menopause on asthma.
OBJECTIVES:We sought to study whether the incidence of asthma and respiratory symptoms differ by menopausal status in a longitudinal population-based study with an average follow-up of 12 years.
METHODS:The Respiratory Health in Northern Europe study provided questionnaire data pertaining to respiratory and reproductive health at baseline (1999-2001) and follow-up (2010-2012). The study cohort included women aged 45 to 65 years at follow-up, without asthma at baseline, and not using exogenous hormones (n = 2322). Menopausal status was defined as nonmenopausal, transitional, early postmenopausal, and late postmenopausal. Associations with asthma (defined by the use of asthma medication, having asthma attacks, or both) and respiratory symptoms scores were analyzed by using logistic (asthma) and negative binomial (respiratory symptoms) regressions, adjusting for age, body mass index, physical activity, smoking, education, and study center.
RESULTS:The odds of new-onset asthma were increased in women who were transitional (odds ratio, 2.40; 95% CI, 1.09-5.30), early postmenopausal (odds ratio, 2.11; 95% CI, 1.06-4.20), and late postmenopausal (odds ratio, 3.44; 95% CI, 1.31-9.05) at follow-up compared with nonmenopausal women. The risk of respiratory symptoms increased in early postmenopausal (coefficient, 0.40; 95% CI, 0.06-0.75) and late postmenopausal (coefficient, 0.69; 95% CI, 0.15-1.23) women. These findings were consistent irrespective of smoking status and across study centers.
CONCLUSIONS:New-onset asthma and respiratory symptoms increased in women becoming postmenopausal in a longitudinal population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging.
 

JAllergyClinImmunol. 2015Oct1.pii:S0091-6749(15)01243-9.doi:10.1016/j.jaci.2015.08.019. [Epub ahead of print]