Kai Triebner1, Ane Johannessen2, Luca Puggini3, Bryndís Benediktsdóttir4, Randi J Bertelsen5, Ersilia Bifulco6, Shyamali C Dharmage7, Julia Dratva8, Karl A Franklin9, Thórarinn Gíslason10, Mathias Holm11, Deborah Jarvis12, Bénédicte Leynaert13, Eva Lindberg14, Andrei Malinovschi15, Ferenc Macsali16, Dan Norbäck17, Ernst R Omenaas2, Francisco J Rodríguez18, Eirunn Saure5, Vivi Schlünssen19, Torben Sigsgaard19, Trude D Skorge5, Gunilla Wieslander17, Elisabeth Zemp8, Cecilie Svanes5, Steinar Hustad6, Francisco Gómez Real20. 1. Department of Clinical Science, University of Bergen, Bergen, Norway. Electronic address: kai.triebner@uib.no. 2. Department of Clinical Science, University of Bergen, Bergen, Norway. 3. Department of Electronic Engineering National University of Ireland, Maynooth, Ireland. 4. Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 5. Department of Occupational Medicine, University of Bergen, Bergen, Norway. 6. Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway. 7. Allergy and Lung Health Unit, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia. 8. Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. 9. Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden. 10. Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali-the National University Hospital of Iceland, Reykjavik, Iceland. 11. Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden. 12. Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom. 13. Inserm UMR1152 Team of Epidemiology, Paris, France. 14. Department of Medical Sciences, Lung Medicine and Allergology, Uppsala University, Uppsala, Sweden. 15. Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden. 16. Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway. 17. Department of Medical Sciences, Occupational and Environmental Medicine, University of Uppsala, Uppsala, Sweden. 18. Department of Applied Mathematics, Málaga University, Málaga, Spain. 19. Department of Public Health, Aarhus University, Aarhus, Denmark. 20. Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
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.
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.