Lifetime female hormonal exposure and risk of rheumatoid arthritis in postmenopausal women: Results from the French E3N cohort - 21/09/22
Highlights |
• | The female ratio and a postmenopausal peak of incidence suggest a possible role of hormonal factors in RA physiopathology. |
• | Reproductive span, total ovulatory years and lifetime duration of hormonal exposure combining both endogenous and exogenous exposures were not associated with RA in postmenopausal women. |
• | However, high lifelong estrogen exposure was inversely associated with the risk of RA in postmenopausal women. |
Abstract |
Objective |
To assess the relationships between lifetime female hormonal exposures and the risk of incident RA in postmenopausal women.
Methods |
E3N is an ongoing French prospective cohort of 98,995 women since 1990 aged 40–65 years at enrolment. Data on reproductive/hormonal factors and treatments were regularly recorded. Exposures were defined as follows: – reproductive span (in years)=duration from menarche to menopause; – total ovulatory years=reproductive span−(number of full-term pregnancies×0.75+number of miscarriages×0.25+total duration of breast feeding+total duration of oral contraception); – lifetime duration of hormonal exposure (in years)=reproductive span+total duration of menopausal hormonal therapy; – composite estrogen score (CES, range=0–6): 1 point for each item: early menarche, high parity, history of hysterectomy, use of oral contraception, use of menopausal hormonal therapy and late menopause. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of incident RA were estimated using Cox proportional hazards regression models with age as the time scale.
Results |
Among the 78,391 postmenopausal cohort women, 637 validated incident RA cases occurred. Lifetime durations of hormonal exposures were not associated with incident RA in postmenopausal women. High (CES=4–6) versus low (CES=0–1) estrogen exposure was inversely associated with the risk of RA: HR 0.37; 95% CI 0.2–0.8.
Conclusion |
In the E3N cohort, high lifetime estrogen exposure, that summarizes cumulative endogenous and exogenous exposures, was associated with a decreased risk of RA in postmenopausal women.
Le texte complet de cet article est disponible en PDF.Keywords : Rheumatoid arthritis, Prospective cohort, Lifetime estrogen exposure
Plan
Vol 89 - N° 5
Article 105374- octobre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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