Postmenopausal hormone therapy and asthma onset in the E3N cohort
- Isabelle Romieu1,
- Alban Fabre2,
- Agnes Fournier2,
- Francine Kauffmann3,
- Raphaëlle Varraso3,
- Sylvie Mesrine2,
- Benedicte Leynaert4,
- Francoise Clavel-Chapelon2
- 1National Instituto of Public Health, Cuernavaca, Mexico
- 2INSERM, ER120/Université Paris-Sud, Faculté de Médicine, IFR69/Institut Gustave Roussy, Villejuif, France
- 3INSERM, U780/Université Paris-Sud, Faculté de Médicine, IFR69 Villejuif, France
- 4INSERM, U700 Paris, France
- Correspondence to Dr Isabelle Romieu, Instituto Nacional de Salud Publica, Av. Universidad # 655, Col Santa Maria Ahuacatitlan, CP 62100, Cuernavaca, Morelos, México;
- Received 13 March 2009
- Accepted 13 October 2009
- Published Online First 8 February 2010
Background Epidemiological studies have suggested that female hormones might play a role in asthma and that menopausal hormone therapy (MHT or hormone replacement therapy (HRT)) might increase the risk of asthma in postmenopausal women. The only prospective study addressing this issue reports an increase in the risk of developing asthma which was similar for oestrogen alone and oestrogen/progestagen treatment.
Methods The association between the use of different types of MHT and the risk of asthma onset in postmenopausal women was investigated prospectively from 1990 to 2002 by biennial questionnaires as part of the French E3N cohort study. Asthma onset was considered to be the time of medical diagnosis of asthma cases occurring during the follow-up of women who were asthma free at baseline. Cox proportional hazards models were used, adjusting for potential confounding factors.
Results Among 57 664 women free of asthma at menopause, 569 incident cases of asthma were identified during 495 448 years of follow-up. MHT was related to an increased risk of asthma onset (HR=1.20, 95% CI 0.98 to 1.46) among recent users. The increase in risk of asthma onset was only significant among women reporting the use of oestrogen alone (HR=1.54, 95% CI 1.13 to 2.09) particularly in never smokers (HR=1.80, 95% CI 1.15 to 2.80) and women reporting allergic disease prior to asthma onset (HR=1.86, 95% CI 1.18 to 2.93). A small increase in the risk of asthma onset associated with the use of oestrogen/progestagen was also observed in these subgroups.
Conclusion Postmenopausal use of oestrogen alone was associated with an increased rate of newly diagnosed asthma in menopausal women.
- menopausal hormone therapy (MHT)
- hormone replacement therapy (HRT)
- asthma epidemiology
- macrophage biology
Funding Mutuelle Générale de l'Education Nationale, the Institut de Cancérologie Gustave Roussy and the Institut National de la Santé et de la Recherche Médicale. IR was supported by the National Center for Environmental Health-Centers for Disease Control and Prevention, Atlanta, Georgia, USA. AF was supported by the Cancéropôle Région Ile de France. BL was supported by the GA2LEN project (EU contract FOODCT-2004-506378).
Competing interests None.
Ethics approval The study was approved by the French National Commission for Data Protection and Privacy.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.