Lung function, respiratory symptoms, and the menopausal transition

Francisco Gómez Real; Cecilie Svanes; Ernst Reidar Omenaas; Josep Maria Antò; Estel Plana; Deborah Jarvis; Christer Janson; Françoise Neukirch; Elisabeth Zemp; Julia Dratva; Matthias Wjst; Knut Svanes; Bénédicte Leynaert; Jordi Sunyer

doi:10.1016/j.jaci.2007.08.057

Lung function, respiratory symptoms, and the menopausal transition

Francisco Gómez Real^*, Cecilie Svanes, Ernst Reidar Omenaas, Josep Maria Antò, Estel Plana, Deborah Jarvis, Christer Janson, Françoise Neukirch, Elisabeth Zemp, Julia Dratva, Matthias Wjst, Knut Svanes, Bénédicte Leynaert, Jordi Sunyer

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

99 Citations (Scopus)

Abstract

Background: There is limited information on potential changes in respiratory health when women enter the menopausal transition. Objective: We sought to investigate whether the menopausal transition is related to lung function and asthma and whether body mass index (BMI) modifies associations. Methods: Four 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. Results: Women 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], P_interaction: .04; FEV₁ adjusted difference, -54 [95% CI, -151 to 43], P_interaction = .06). Conclusions: Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women.

Original language	English
Pages (from-to)	72-80.e3
Journal	Journal of Allergy and Clinical Immunology
Volume	121
Issue number	1
DOIs	https://doi.org/10.1016/j.jaci.2007.08.057
Publication status	Published - Jan 2008
Externally published	Yes

Bibliographical note

Funding Information:
Bergen—Norwegian Research Council; Norwegian Asthma and Allergy Association (NAAF); Glaxo Wellcome AS, Norway Research Fund.

Funding Information:
Pavia—Glaxo, Smith and Kline Italy, Italian Ministry of University and Scientific and Technological Research (MURST), Local University Funding for Research 1998 and 1999 (Pavia, Italy).

Funding Information:
Erfurt—GSF–National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (DFG; grant code FR 1526/1-1).

Funding Information:
Belgian Science Policy Office, National Fund for Scientific Research; Ministère de la Santé, Glaxo France, Institut Pneumologique d'Aquitaine, Contrat de Plan Etat-Région Languedoc-Rousillon, CNMATS, CNMRT (90MR/10, 91AF/6), Ministre delegué de la santé, RNSP, France; GSF, and the Bundesminister für Forschung und Technologie, Bonn, Germany; Ministero dell'Università e della Ricerca Scientifica e Tecnologica, CNR, Regione Veneto grant RSF no. 381/05.93, Italy; Norwegian Research Council project no. 101422/310; Dutch Ministry of Wellbeing, Public Health and Culture, Netherlands; Ministerio de Sanidad y Consumo FIS (grants no. 91/0016060/00E-05E and 93/0393), and grants from Hospital General de Albacete, Hospital General Juan.

Funding Information:
Basel—Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund (SUVA).

Funding Information:
Antwerp—FWO (Fund for Scientific Research)– Flanders Belgium (grant code: G.0402.00), University of Antwerp, Flemish Health Ministry.

Funding Information:
Hamburg—GSF–National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (DFG; grant code MA 711/4-1).

Funding Information:
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.

Funding Information:
Ramón Jiménez, Consejería de Sanidad, Principado de Asturias, Spain; The Swedish Medical Research Council, the Swedish Heart Lung Foundation, the Swedish Association against Asthma and Allergy; Swiss National Science Foundation grant 4026-28099; National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority, United Kingdom; United States Department of Health, Education and Welfare Public Health Service (grant no. 2 S07 RR05521-28).

Keywords

European Community Respiratory Health Survey
Menopause
allergy
asthma
body mass index
estrogens
follicle-stimulating hormone
hormone replacement therapy
lung function
sex hormones

Access to Document

10.1016/j.jaci.2007.08.057

Cite this

@article{617fb95c6afc41ff93395dcc74db8c02,

title = "Lung function, respiratory symptoms, and the menopausal transition",

abstract = "Background: There is limited information on potential changes in respiratory health when women enter the menopausal transition. Objective: We sought to investigate whether the menopausal transition is related to lung function and asthma and whether body mass index (BMI) modifies associations. Methods: Four 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. Results: Women 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). Conclusions: Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women.",

keywords = "European Community Respiratory Health Survey, Menopause, allergy, asthma, body mass index, estrogens, follicle-stimulating hormone, hormone replacement therapy, lung function, sex hormones",

author = "Real, {Francisco G{\'o}mez} and Cecilie Svanes and Omenaas, {Ernst Reidar} and Ant{\`o}, {Josep Maria} and Estel Plana and Deborah Jarvis and Christer Janson and Fran{\c c}oise Neukirch and Elisabeth Zemp and Julia Dratva and Matthias Wjst and Knut Svanes and B{\'e}n{\'e}dicte Leynaert and Jordi Sunyer",

note = "Funding Information: Bergen—Norwegian Research Council; Norwegian Asthma and Allergy Association (NAAF); Glaxo Wellcome AS, Norway Research Fund. Funding Information: Pavia—Glaxo, Smith and Kline Italy, Italian Ministry of University and Scientific and Technological Research (MURST), Local University Funding for Research 1998 and 1999 (Pavia, Italy). Funding Information: Erfurt—GSF–National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (DFG; grant code FR 1526/1-1). Funding Information: Belgian Science Policy Office, National Fund for Scientific Research; Minist{\`e}re de la Sant{\'e}, Glaxo France, Institut Pneumologique d'Aquitaine, Contrat de Plan Etat-R{\'e}gion Languedoc-Rousillon, CNMATS, CNMRT (90MR/10, 91AF/6), Ministre delegu{\'e} de la sant{\'e}, RNSP, France; GSF, and the Bundesminister f{\"u}r Forschung und Technologie, Bonn, Germany; Ministero dell'Universit{\`a} e della Ricerca Scientifica e Tecnologica, CNR, Regione Veneto grant RSF no. 381/05.93, Italy; Norwegian Research Council project no. 101422/310; Dutch Ministry of Wellbeing, Public Health and Culture, Netherlands; Ministerio de Sanidad y Consumo FIS (grants no. 91/0016060/00E-05E and 93/0393), and grants from Hospital General de Albacete, Hospital General Juan. Funding Information: Basel—Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund (SUVA). Funding Information: Antwerp—FWO (Fund for Scientific Research)– Flanders Belgium (grant code: G.0402.00), University of Antwerp, Flemish Health Ministry. Funding Information: Hamburg—GSF–National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (DFG; grant code MA 711/4-1). Funding Information: 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 Comit{\'e} National contre les Maladies Respiratoires (CNMR) and the Centre d'Investigation Clinique (CIC), Bichat Hospital. Funding Information: Ram{\'o}n Jim{\'e}nez, Consejer{\'i}a de Sanidad, Principado de Asturias, Spain; The Swedish Medical Research Council, the Swedish Heart Lung Foundation, the Swedish Association against Asthma and Allergy; Swiss National Science Foundation grant 4026-28099; National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority, United Kingdom; United States Department of Health, Education and Welfare Public Health Service (grant no. 2 S07 RR05521-28).",

year = "2008",

month = jan,

doi = "10.1016/j.jaci.2007.08.057",

language = "English",

volume = "121",

pages = "72--80.e3",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Elsevier Inc.",

number = "1",

}

TY - JOUR

T1 - Lung function, respiratory symptoms, and the menopausal transition

AU - Real, Francisco Gómez

AU - Svanes, Cecilie

AU - Omenaas, Ernst Reidar

AU - Antò, Josep Maria

AU - Plana, Estel

AU - Jarvis, Deborah

AU - Janson, Christer

AU - Neukirch, Françoise

AU - Zemp, Elisabeth

AU - Dratva, Julia

AU - Wjst, Matthias

AU - Svanes, Knut

AU - Leynaert, Bénédicte

AU - Sunyer, Jordi

N1 - Funding Information: Bergen—Norwegian Research Council; Norwegian Asthma and Allergy Association (NAAF); Glaxo Wellcome AS, Norway Research Fund. Funding Information: Pavia—Glaxo, Smith and Kline Italy, Italian Ministry of University and Scientific and Technological Research (MURST), Local University Funding for Research 1998 and 1999 (Pavia, Italy). Funding Information: Erfurt—GSF–National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (DFG; grant code FR 1526/1-1). Funding Information: Belgian Science Policy Office, National Fund for Scientific Research; Ministère de la Santé, Glaxo France, Institut Pneumologique d'Aquitaine, Contrat de Plan Etat-Région Languedoc-Rousillon, CNMATS, CNMRT (90MR/10, 91AF/6), Ministre delegué de la santé, RNSP, France; GSF, and the Bundesminister für Forschung und Technologie, Bonn, Germany; Ministero dell'Università e della Ricerca Scientifica e Tecnologica, CNR, Regione Veneto grant RSF no. 381/05.93, Italy; Norwegian Research Council project no. 101422/310; Dutch Ministry of Wellbeing, Public Health and Culture, Netherlands; Ministerio de Sanidad y Consumo FIS (grants no. 91/0016060/00E-05E and 93/0393), and grants from Hospital General de Albacete, Hospital General Juan. Funding Information: Basel—Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund (SUVA). Funding Information: Antwerp—FWO (Fund for Scientific Research)– Flanders Belgium (grant code: G.0402.00), University of Antwerp, Flemish Health Ministry. Funding Information: Hamburg—GSF–National Research Centre for Environment and Health, Deutsche Forschungsgemeinschaft (DFG; grant code MA 711/4-1). Funding Information: 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. Funding Information: Ramón Jiménez, Consejería de Sanidad, Principado de Asturias, Spain; The Swedish Medical Research Council, the Swedish Heart Lung Foundation, the Swedish Association against Asthma and Allergy; Swiss National Science Foundation grant 4026-28099; National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority, United Kingdom; United States Department of Health, Education and Welfare Public Health Service (grant no. 2 S07 RR05521-28).

PY - 2008/1

Y1 - 2008/1

N2 - Background: There is limited information on potential changes in respiratory health when women enter the menopausal transition. Objective: We sought to investigate whether the menopausal transition is related to lung function and asthma and whether body mass index (BMI) modifies associations. Methods: Four 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. Results: Women 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). Conclusions: Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women.

AB - Background: There is limited information on potential changes in respiratory health when women enter the menopausal transition. Objective: We sought to investigate whether the menopausal transition is related to lung function and asthma and whether body mass index (BMI) modifies associations. Methods: Four 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. Results: Women 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). Conclusions: Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women.

KW - European Community Respiratory Health Survey

KW - Menopause

KW - allergy

KW - asthma

KW - body mass index

KW - estrogens

KW - follicle-stimulating hormone

KW - hormone replacement therapy

KW - lung function

KW - sex hormones

UR - http://www.scopus.com/inward/record.url?scp=38149036430&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2007.08.057

DO - 10.1016/j.jaci.2007.08.057

M3 - Article

C2 - 18028993

AN - SCOPUS:38149036430

SN - 0091-6749

VL - 121

SP - 72-80.e3

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 1

ER -