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Maturitas. 2019 Feb;120:29-34. doi: 10.1016/j.maturitas.2018.11.007. Epub 2018 Nov 19.

Exogenous female sex steroids may reduce lung ageing after menopause: A 20-year follow-up study of a general population sample (ECRHS).

Author information

1
Department of Clinical Science, University of Bergen, Jonas Lies veg 87, 5021 Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Jonas Lies veg 87, 5021, Bergen, Norway. Electronic address: kai.triebner@uib.no.
2
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Institute of Biology II, Strada Le Grazie 8, 37134 Verona, Italy.
3
Department of Occupational Medicine, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway; Centre for International Health, University of Bergen, Jekteviksbakken 31, 5009 Bergen Bergen, Norway.
4
Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
5
Department of Clinical Science, University of Bergen, Jonas Lies veg 87, 5021 Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Jonas Lies veg 87, 5021, Bergen, Norway.
6
Department of Pulmonology - Division of Allergy, University Hospital of Montpellier, University Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France; Sorbonne University, French National Institute of Health and Medical Research, Pierre Louis Institute of Epidemiology and Public Health, 56 Boulevard Vincent-Auriol, 75646 Paris, France.
7
Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, 3052 Carlton, Australia.
8
Department of Surgical and Perioperative Sciences, Surgery, Umea University, Koksvagen 11, 90185 Umea, Sweden.
9
ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain; University Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiology and Public Health, Doctor Aiguader 88, 08003 Barcelona, Spain.
10
Pneumology Department University Hospital San Agustín, Camino Heros 4, 33410, Avilés, Spain.
11
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilian University Munich, Ziemssenstrasse 1, 80336 Munich, Germany.
12
Department of Occupational and Environmental Medicine, University of Gothenburg, Medicinaregatan 16A, 41390 Gothenburg, Sweden.
13
National Heart and Lung Institute, 1b Manresa Road SW3 6LR, Imperial College, London, United Kingdom.
14
Department of Lung Medicine, Tartu University Hospital, Lung Clinic, Riia 167, Tartu 51014, Estonia.
15
Department of Medical Sciences, Respiratory, allergy and sleep research, Uppsala University, Akademiska sjukhuset Ing. 40, Uppsala, Sweden.
16
Pulmonology Service, Albacete University Hospital Complex, Health Service of Castilla - La Mancha, Albacete, Spain; Faculty of Medicine of Albacete, Castilla-La Mancha University, Albacete, Spain.
17
Unit of Epidemiology and Public Health, Department of Health, Basque Government, Alameda Rekalde 39A, 48008 Bilbao, Spain.
18
Department of Pediatrics, University Hospital Grenoble Alpes, French National Institute of Health and Medical Research, Institute for Advanced Biosciences, University Grenoble Alpes, CS 10217, 38043 Grenoble cedex 9, France.
19
Swiss Tropical and Public Health Institute, Socinstrasse 58, 4002 Basel, Switzerland; Department of Public Health, University of Basel, Petersplatz 1, 4001 Basel, Switzerland.
20
U1219, Bordeaux Population Health Research, Bordeaux University, 146 rue Leo Saignat, 33076 Bordeaux, France.
21
Department of Nursing, University of Huelva, Avenida Tres de Marzo, s/n 21071, Huelva, Spain.
22
Department of Public Health, Aarhus University, Bartholins Alle 2, 8000 Aarhus, Denmark; National Research Centre for the Working Environment, Lersø Parkalle 105, 2100 Copenhagen, Denmark.
23
Team of Epidemiology, French National Institute of Health and Medical Research UMR1152, Paris, France.
24
Department of Clinical Science, University of Bergen, Jonas Lies veg 87, 5021 Bergen, Norway; Department of Gynecology and Obstetrics, Haukeland University Hospital, Jonas Lies veg 65, 5021 Bergen, Norway.

Abstract

OBJECTIVES:

Menopause involves hypoestrogenism, which is associated with numerous detrimental effects, including on respiratory health. Hormone replacement therapy (HRT) is often used to improve symptoms of menopause. The effects of HRT on lung function decline, hence lung ageing, have not yet been investigated despite the recognized effects of HRT on other health outcomes.

STUDY DESIGN:

The population-based multi-centre European Community Respiratory Health Survey provided complete data for 275 oral HRT users at two time points, who were matched with 383 nonusers and analysed with a two-level linear mixed effects regression model.

MAIN OUTCOME MEASURES:

We studied whether HRT use was associated with the annual decline in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1).

RESULTS:

Lung function of women using oral HRT for more than five years declined less rapidly than that of nonusers. The adjusted difference in FVC decline was 5.6 mL/y (95%CI: 1.8 to 9.3, p = 0.01) for women who had taken HRT for six to ten years and 8.9 mL/y (3.5 to 14.2, p = 0.003) for those who had taken it for more than ten years. The adjusted difference in FEV1 decline was 4.4 mL/y (0.9 to 8.0, p = 0.02) with treatment from six to ten years and 5.3 mL/y (0.4 to 10.2, p = 0.048) with treatment for over ten years.

CONCLUSIONS:

In this longitudinal population-based study, the decline in lung function was less rapid in women who used HRT, following a dose-response pattern, and consistent when adjusting for potential confounding factors. This may signify that female sex hormones are of importance for lung ageing.

KEYWORDS:

Hormone replacement therapy (HRT); Lung function; Menopause; Reproductive aging; Sex hormones

PMID:
30583761
DOI:
10.1016/j.maturitas.2018.11.007
[Indexed for MEDLINE]
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