Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study
Abstract Background Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women. Methods We cond...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-023-03038-8 |
| _version_ | 1797363266013364224 |
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| author | Guoqiang Zhang Rani Basna Maya B. Mathur Cecilia Lässer Roxana Mincheva Linda Ekerljung Göran Wennergren Madeleine Rådinger Bo Lundbäck Hannu Kankaanranta Bright I. Nwaru |
| author_facet | Guoqiang Zhang Rani Basna Maya B. Mathur Cecilia Lässer Roxana Mincheva Linda Ekerljung Göran Wennergren Madeleine Rådinger Bo Lundbäck Hannu Kankaanranta Bright I. Nwaru |
| author_sort | Guoqiang Zhang |
| collection | DOAJ |
| description | Abstract Background Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women. Methods We conducted a matched case–control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16–75 years, with 8-year follow-up (2008–2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models. Results We included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95% confidence interval [CI] 1.03–4.38). Subgroup analyses showed that the OR increased consistently with older baseline age. The OR for new-onset asthma with ever MHT use among menopausal women was 1.17 (95% CI 0.49–2.82). In Bayesian analysis, the ORs for ever use of hormonal contraceptives and MHT were, respectively, 1.11 (95% posterior interval [PI] 0.79–1.55) and 1.18 (95% PI 0.92–1.52). The respective probability of each OR being larger than 1 was 72.3% and 90.6%. Conclusions Although use of hormonal contraceptives was associated with an increased risk of asthma, this may be explained by selection of women by baseline asthma status, given the upward trend in the effect estimate with older age. This indicates that use of hormonal contraceptives may in fact decrease asthma risk in women. Use of MHT may increase asthma risk in menopausal women. |
| first_indexed | 2024-03-08T16:17:50Z |
| format | Article |
| id | doaj.art-e795ee82822a40ca863c160ae72a16bd |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-03-08T16:17:50Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-e795ee82822a40ca863c160ae72a16bd2024-01-07T12:29:33ZengBMCBMC Medicine1741-70152023-09-0121111510.1186/s12916-023-03038-8Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control studyGuoqiang Zhang0Rani Basna1Maya B. Mathur2Cecilia Lässer3Roxana Mincheva4Linda Ekerljung5Göran Wennergren6Madeleine Rådinger7Bo Lundbäck8Hannu Kankaanranta9Bright I. Nwaru10Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgQuantitative Sciences Unit, Stanford UniversityKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgDepartment of Pediatrics, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgKrefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of GothenburgAbstract Background Evidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women. Methods We conducted a matched case–control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16–75 years, with 8-year follow-up (2008–2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models. Results We included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95% confidence interval [CI] 1.03–4.38). Subgroup analyses showed that the OR increased consistently with older baseline age. The OR for new-onset asthma with ever MHT use among menopausal women was 1.17 (95% CI 0.49–2.82). In Bayesian analysis, the ORs for ever use of hormonal contraceptives and MHT were, respectively, 1.11 (95% posterior interval [PI] 0.79–1.55) and 1.18 (95% PI 0.92–1.52). The respective probability of each OR being larger than 1 was 72.3% and 90.6%. Conclusions Although use of hormonal contraceptives was associated with an increased risk of asthma, this may be explained by selection of women by baseline asthma status, given the upward trend in the effect estimate with older age. This indicates that use of hormonal contraceptives may in fact decrease asthma risk in women. Use of MHT may increase asthma risk in menopausal women.https://doi.org/10.1186/s12916-023-03038-8AsthmaBayesian estimationCase–controlHormonal contraceptivesMenopausal hormone therapyWomen |
| spellingShingle | Guoqiang Zhang Rani Basna Maya B. Mathur Cecilia Lässer Roxana Mincheva Linda Ekerljung Göran Wennergren Madeleine Rådinger Bo Lundbäck Hannu Kankaanranta Bright I. Nwaru Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study BMC Medicine Asthma Bayesian estimation Case–control Hormonal contraceptives Menopausal hormone therapy Women |
| title | Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study |
| title_full | Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study |
| title_fullStr | Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study |
| title_full_unstemmed | Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study |
| title_short | Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study |
| title_sort | exogenous female sex steroid hormones and new onset asthma in women a matched case control study |
| topic | Asthma Bayesian estimation Case–control Hormonal contraceptives Menopausal hormone therapy Women |
| url | https://doi.org/10.1186/s12916-023-03038-8 |
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