Perimenstrual increase in bronchial hyperreactivity in premenopausal women: Results from the population-based SAPALDIA 2 cohort - 20/08/11
, Christian Schindler, PhD a, Ivan Curjuric, MD a, Daiana Stolz, MD, MPH b, Ferenc Macsali, MD c, Francisco Real Gomez, MD, PhD c, Elisabeth Zemp, MD, MPH aSAPALDIA Team
Reprint requests: Julia Dratva, MD, MPH, Institute of Social and Preventive Medicine at the Swiss Tropical Institute, Steinengraben 49, 4051 Basel, Switzerland.Abstract |
Background |
Studies on perimenstrual asthma are inconsistent, and different methodologies limit comparisons.
Objective |
To investigate cyclic variations in bronchial hyperreactivity (BHR) to methacholine in premenopausal women in a population-based cohort and assess effect modification by oral contraceptives (OCs).
Methods |
Day of menstruation cycle at the time of methacholine challenge was calculated in 571 menstruating women without hormonal treatment, age 28 to 58 years, on the basis of questionnaire data from the Swiss cohort study on Air Pollution And Lung Disease In Adults (SAPALDIA) cohort 2001/2002. A window of risk was defined 3 days before and after the first day of menstruation. Logistic and linear regression analyses were performed adjusting for main predictors of BHR and stratifying for asthma status. The impact of OCs was studied in the same sample enlarged by 130 women taking OCs.
Results |
The prevalence of BHR was 13% (fall of ≥20% in FEV1 up to a maximal cumulative dose of 2 mg), and 6% had asthma. A total of 143 women had undergone methacholine challenge within the risk window. We observed a significant increase in BHR within the window of risk (odds ratio [OR], 2.3; 95% CI, 1.27-4.29). A cyclic association pattern was confirmed by trigonometric functions. Effect modification by asthma status and oral contraceptive use was found, with lower OR in subjects without asthma and OR <1 in women using OCs.
Conclusion |
The data provide evidence of a systematic variation in BHR during the menstruation cycle, supporting the hypothesis of a hormonal influence. OCs appear to have a protective effect. Cyclicity of BHR could be of clinical importance in view of future medication recommendations and timing of respiratory function tests in women.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, bronchial hyperreactivity, epidemiology, menstruation, methacholine challenge test, oral contraceptives, premenstrual
Abbreviations used : BHR, BMI, CRP, FEV1, OC, OR, PMA, SAPALDIA
Plan
| SAPALDIA is supported by the Swiss National Science Foundation (grant nos. 4026-28099, 3347CO-108796, 3247BO-104283, 3247BO-104288, 3247BO-104284, 32-65896.01, 32-59302.99, 32-52720.97, and 32-4253.94); the Federal Office for Forest, Environment and Landscape; the Federal Office of Public Health; the Federal Office of Roads and Transport; the Cantonal Governments of Aargau, Basel-Stadt, Basel-Landschaft, Geneva, Lucerne, Ticino, and Zurich; the Swiss Lung League; and the Cantonal Lung Leagues of Basel Stadt/Basel Landschaft, Geneva, Ticino, and Zurich. |
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| Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest. |
Vol 125 - N° 4
P. 823-829 - avril 2010 Retour au numéro
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