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美国成人全国研究中的性激素与哮喘水平

2020/03/11

   摘要
   理论依据:女性比男性发生哮喘的比例更高。尽管性激素可以解释哮喘中存在的性别差异,但其在哮喘发生发展中的作用尚不清楚。
   目的:检测成人性激素和哮喘水平。
   方法:入组2013-2014及2015-2016年间参与美国国家健康与营养检测调查、年龄在18-79岁的7615名成年人(其中包括3953名男性和3662名女性),对其血清游睾酮、雌二醇水平以及当前哮喘水平进行横断面研究。利用Logistic回归分别在男性人群及女性人群中进行哮喘与性激素的多变量分析。
   测量方法和主要结果:女性人群中,血清游离睾酮的四分位数与当前低哮喘发病率相关(Q4:Q1的OR值为0.56;95%CI为0.39-0.80)。考虑到哮喘患者中肥胖与性激素之间的相互作用,对肥胖程度进行分层。在肥胖女性中,血清睾酮升高(Q4比Q1 OR值为0.59;95%CI为0.37-0.91)及雌二醇升高(Q4比Q1 OR值为0.43;95%CI为0.23-0.78)与较低哮喘发病率相关。在非肥胖男性中,血清雌二醇升高(Q4比Q1 OR值为0.44;95%CI为0.21-0.90)与当前较低哮喘发生率相关。
   结论:该研究表明性激素在成人哮喘的已知性别差异中具有重要作用。此外,研究结果表明肥胖能够调节性激素对成人哮喘的影响。

 
(中日友好医院呼吸与危重症医学科 张鑫 翻译 林江涛 审校)
(Am J Respir Crit Care Med. 2020 Jan 15;201(2):158-166. doi: 10.1164/rccm.201905-0996OC.)

 
 
 
Sex Steroid Hormones and Asthma in a Nationwide Study of U.S. Adults.
 
Han YY, Forno E, Celedón JC.
 
Abstract
Rationale: Women have a higher burden of asthma than men. Although sex hormones may explain sex differences in asthma, their role is unclear.
Objectives: To examine sex hormone levels and asthma in adults.
Methods: Cross-sectional study of serum levels of free testosterone and estradiol and current asthma in 7,615 adults (3,953 men and 3,662 women) aged 18-79 years who participated in the 2013-2014 and 2015-2016 U.S. National Health and Nutrition Examination Survey. Logistic regression was used for the multivariable analysis of sex hormones and current asthma, which was conducted separately in women and men.
Measurements and Main Results:Free testosterone levels in the fourth quartile were associated with lower odds of current asthma in women (odds ratio [OR] for the fourth quartile [Q4] vs. Q1, 0.56; 95% confidence interval [CI], 0.39-0.80). Given an interaction between obesity and sex hormones on current asthma, we stratified the analysis by obesity. In this analysis, elevated free testosterone (OR for Q4 vs. Q1, 0.59; 95% CI, 0.37-0.91) and estradiol (OR for Q4 vs. Q1, 0.43; 95% CI, 0.23-0.78) levels were associated with reduced odds of current asthma in obese women, and an elevated serum estradiol was associated with lower odds of current asthma in nonobese men (OR for Q4 vs. Q1, 0.44; 95% CI, 0.21-0.90).
Conclusions: Our findings suggest that sex hormones play a role in known sex differences in asthma in adults. Moreover, our results suggest that obesity modifies the effects of sex hormones on asthma in adults.




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