| | Lung function, respiratory symptoms, and the menopausal transitionReceived 27 June 2007; received in revised form 23 August 2007; accepted 27 August 2007. published online 29 October 2007. BackgroundThere is limited information on potential changes in respiratory health when women enter the menopausal transition. ObjectiveWe sought to investigate whether the menopausal transition is related to lung function and asthma and whether body mass index (BMI) modifies associations. MethodsFour thousand two hundred fifty-nine women from 21 centers (ECRHS II, 2002) responded to a questionnaire concerning women's health. Women aged 45 to 56 years not using exogenous sex hormones (n = 1274) were included in the present analysis. Lung function measurements (n = 1120) and serum markers of hormonal status (follicle-stimulating hormone, luteinizing hormone, and estradiol; n = 710) were available. Logistic and linear regression analyses were adjusted for BMI, age, years of education, smoking status, center, and height. ResultsWomen not menstruating for the last 6 months (n = 432, 34%) had significantly lower FEV1 values (−120 mL [95% CI, −177 to −63]), lower forced vital capacity values (−115 mL [95% CI, −181 to −50]), and more respiratory symptoms (odds ratio [OR], 1.82 [95% CI, 1.27-2.61]) than those menstruating regularly. Results were similar when restricting analyses to those who never smoked. Associations were significantly stronger in women with BMIs of less than 23 kg/m2 (respiratory symptoms: OR, 4.07 [95% CI, 1.88-8.80]; FEV1 adjusted difference: −166 [95% CI, −263 to −70]) than in women with BMIs of 23 to 28 kg/m2 (respiratory symptoms: OR, 1.10 [95% CI, 0.61-1.97], Pinteraction: .04; FEV1 adjusted difference, −54 [95% CI, −151 to 43], Pinteraction = .06). ConclusionsMenopause is associated with lower lung function and more respiratory symptoms, especially among lean women. Abbreviations used: BMI, Body mass index, COPD, Chronic obstructive pulmonary disease, ECRHS, European Community Respiratory Health Survey, FSH, Follicle-stimulating hormone, FVC, Forced vital capacity, GAM, Generalized additive model, HRT, Hormone replacement therapy, LH, Luteinizing hormone, OR, Odds ratio, RHINE, Respiratory Health in Northern Europe a Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway b Centre de Recerca en Epidemiologia Ambiental (CREAL)–Institut Municipal d'Investigació Mèdica (IMIM-IMAS), Barcelona, Spain c Respiratory Research Group, Institute of Medicine, University of Bergen, Bergen, Norway d Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway e Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway f Departament de Ciencies Experimentals i de la Vida-Universitat Pompeu Fabra (UPF), Barcelona, Spain g Department of Public Health Sciences, Imperial College, London, United Kingdom h Department of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden i Epidémiologie des Maladies Respiratoires, INSERM U700, Faculté de Médecine Xavier Bichat, Paris, France j Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland k Molecular Epidemiology, GSF National Research Center for Environment and Health, Neuherberg, Germany l Institute of Surgery, Haukeland University Hospital, Bergen, Norway  Reprint requests: Francisco Gómez Real, MD, Department of Gynecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway.
F.G.R. was supported exclusively by the Norwegian Research Council (grant NFR 161299/V50). European Community Respiratory Health Survey (ECRHS) II was supported by the European Commission, as part of their Quality of Life program. Bodies funding the local studies in ECRHS II are listed in Appendix 1 in the Online Repository at www.jacionline.org. The European Commission supported the transports of serum for hormones measurement to Paris. Hormones measures were funded by the local budget of the ECRHS Paris team, INSERM U700, Epidemiology, with further support from the Comité National contre les Maladies Respiratoires (CNMR) and the Centre d'Investigation Clinique (CIC), Bichat Hospital. Disclosure of potential conflict of interest: E. R. Omenaas has received grant support from the Norwegian Research Council. The rest of the authors have declared that they have no conflict of interest. PII: S0091-6749(07)01658-2 doi:10.1016/j.jaci.2007.08.057 © 2008 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. | |
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