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Am J Respir Crit Care Med. 2017 Apr 15;195(8):1058-1065. doi: 10.1164/rccm.201605-0968OC.

Menopause Is Associated with Accelerated Lung Function Decline.

Author information

1
1 Department of Clinical Science.
2
2 Core Facility for Metabolomics.
3
3 Pathophysiology and Epidemiology of Respiratory Diseases and.
4
4 Department of Global Public Health and Primary Care.
5
5 Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
6
6 Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, France.
7
7 Allergy and Lung Health Unit, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia.
8
8 Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
9
9 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Barcelona, Spain.
10
10 Universitat Pompeu Fabra, Barcelona, Spain.
11
11 Centro de Investigación Biomedica en Red (CIBER), Epidemiología y Salud Pública, Barcelona, Spain.
12
12 Department of Pneumology, Hospital San Agustin de Aviles, Oviedo, Spain.
13
13 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University Munich, Munich, Germany.
14
14 Department of Occupational and Environmental Medicine, University of Gothenburg, Göteborg, Sweden.
15
15 Department of Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, United Kingdom.
16
16 Department of Lung Medicine, Tartu University Clinic, Tartu, Estonia.
17
17 Department of Medical Sciences, Lung, Allergy, and Sleep Research, Uppsala University, Uppsala, Sweden.
18
18 Servicio de Neumología, Servicio de Salud de Castilla - La Mancha, Albacete, Spain.
19
19 Epidemiologia, Salud Pública, Dep. Salud, Gobierno Vasco, Hospital, Galdakao, Spain.
20
20 Pneumologie Pédiatrique, Antenne Pédiatrique du CIC, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.
21
21 Swiss Tropical and Public Health Institute, Basel, Switzerland.
22
22 Department of Public Health, University of Basel, Basel, Switzerland.
23
23 Department of Electronic Engineering, University of Ireland, Maynooth, Ireland.
24
24 U1219, Bordeaux Population Health Research Center, Bordeaux, France.
25
25 Department of Nursing, University of Huelva, Huelva, Spain.
26
26 Department of Public Health, Aarhus University, Aarhus, Denmark.
27
27 National Research Center for the Working Environment, Copenhagen, Denmark.
28
28 Hospital del Mar Medical Research Institute, Barcelona, Spain; and.
29
30 Centre for International Health, and.
30
29 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
31
31 Team of Epidemiology, French National Institute of Health and Medical Research (INSERM), UMR1152, Paris, France.
32
32 Department of Gynecology and Obstetrics, University of Bergen, Bergen, Norway.

Abstract

RATIONALE:

Menopause is associated with changes in sex hormones, which affect immunity, inflammation, and osteoporosis and may impair lung function. Lung function decline has not previously been investigated in relation to menopause.

OBJECTIVES:

To study whether lung function decline, assessed by FVC and FEV1, is accelerated in women who undergo menopause.

METHODS:

The population-based longitudinal European Community Respiratory Health Survey provided serum samples, spirometry, and questionnaire data about respiratory and reproductive health from three study waves (n = 1,438). We measured follicle-stimulating hormone and luteinizing hormone and added information on menstrual patterns to determine menopausal status using latent class analysis. Associations with lung function decline were investigated using linear mixed effects models, adjusting for age, height, weight, pack-years, current smoking, age at completed full-time education, spirometer, and including study center as random effect.

MEASUREMENTS AND MAIN RESULTS:

Menopausal status was associated with accelerated lung function decline. The adjusted mean FVC decline was increased by -10.2 ml/yr (95% confidence interval [CI], -13.1 to -7.2) in transitional women and -12.5 ml/yr (95% CI, -16.2 to -8.9) in post-menopausal women, compared with women menstruating regularly. The adjusted mean FEV1 decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) in post-menopausal women.

CONCLUSIONS:

Lung function declined more rapidly among transitional and post-menopausal women, in particular for FVC, beyond the expected age change. Clinicians should be aware that respiratory health often deteriorates during reproductive aging.

KEYWORDS:

latent class analysis; lung function decline; menopause; reproductive aging; sex hormones

PMID:
27907454
DOI:
10.1164/rccm.201605-0968OC
[Indexed for MEDLINE]
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