PDF(Pubmed)
Abstract：
Sarcoidosis incidence peaks in women between 50 and 60 years old, which coincides with menopause, suggesting that certain sex hormones, mainly estrogen, may play a role in disease development. We investigated whether menopausal hormone therapy (MHT) was associated with sarcoidosis risk in women and whether the risk varied by treatment type. We performed a nested case-control study (2007-2020) including incident sarcoidosis cases from the Swedish National Patient Register (n = 2593) and matched (1:10) to general population controls (n = 20,003) on birth year, county, and living in Sweden at the time of sarcoidosis diagnosis. Dispensations of MHT were obtained from the Swedish Prescribed Drug Register before sarcoidosis diagnosis/matching. Adjusted odds ratios (aOR) of sarcoidosis were estimated using conditional logistic regression. Ever MHT use was associated with a 25% higher risk of sarcoidosis compared with never use (aOR 1.25, 95% CI 1.13-1.38). When MHT type and route of administration were considered together, systemic estrogen was associated with the highest risk of sarcoidosis (aOR 1.51, 95% CI 1.23-1.85), followed by local estrogen (aOR 1.25, 95% CI 1.11-1.42), while systemic estrogen-progestogen combined was associated with the lowest risk compared to never users (aOR 1.12, 95% CI 0.96-1.31). The aOR of sarcoidosis did not differ greatly by duration of MHT use. Our findings suggest that a history of MHT use is associated with increased risk of sarcoidosis, with women receiving estrogen administered systemically having the highest risk.
摘要：
结节病发病率在50至60岁之间的女性中达到高峰，这与更年期相吻合，表明某些性激素，主要是雌激素，可能在疾病发展中发挥作用。我们调查了绝经激素治疗（MHT）是否与女性结节病风险相关，以及风险是否因治疗类型而异。我们进行了一项巢式病例对照研究（2007-2020年），包括瑞典国家患者登记册（n=2593）的结节病病例，并与出生年份的一般人群对照（n=20,003）相匹配（1：10）。县,在结节病诊断时居住在瑞典。在结节病诊断/匹配之前，从瑞典规定的药物登记册中获得MHT的分配。结节病的调整比值比（aOR）使用条件逻辑回归估计。与从未使用MHT相比，曾经使用MHT与结节病的风险高25％（aOR1.25，95％CI1.13-1.38）。当MHT类型和给药途径一起考虑时，全身雌激素与结节病的最高风险相关(aOR1.51,95%CI1.23-1.85),其次是局部雌激素（aOR1.25，95%CI1.11-1.42），而与从未使用过的患者相比,全身性联合使用雌激素-孕激素的风险最低(aOR1.12,95%CI0.96~1.31).结节病的aOR在使用MHT的持续时间上没有很大差异。我们的研究结果表明，使用MHT的历史与结节病的风险增加有关。接受全身雌激素治疗的女性风险最高。
