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首页> 外文期刊>Pulmonary Circulation >Sex hormone exposure and reproductive factors in pulmonary arterial hypertension: a case–control study
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Sex hormone exposure and reproductive factors in pulmonary arterial hypertension: a case–control study

机译：肺动脉高压下的性激素暴露和生殖因子：案例对照研究

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Pulmonary arterial hypertension (PAH) is a sexually dimorphic disease that for unknown reasons affects women more than men. The role of estrogens, both endogenous and exogenous, and reproductive factors in this female susceptibility is still poorly understood. It has been strongly suggested that sex hormones may influence the development and progression of the disease. We sought to determine whether sex hormone exposures and reproductive factors associate with PAH patients compared to control subjects, using a questionnaire and interview to obtain information regarding these potential risk factors. We conducted a single-center unmatched case–control study. Six hundred and thirty-four women and men with PAH, as well as 27 subjects with BMPR2 mutations but no PAH and 132 healthy population controls were enrolled from the Vanderbilt Pulmonary Hypertension Research Cohort and researchmatch.org. Questionnaires and nurse-led interviews were conducted to obtain information regarding sex hormone exposures and reproductive factors. Additional history was obtained on enrolled patients including disease severity variables and comorbidities. Responses to the questionnaires were analyzed to describe these exposures in this population as well as assess the association between disease severity variables and sex hormone exposures. Reproductive and endogenous factors that determine lifelong estrogen exposure were similar between PAH cases and controls. Patients with associated PAH were significantly more likely to be postmenopausal compared to controls. There were similar rates of “ever-use” and duration of use of oral contraceptive pills and hormone replacement therapy in patients when compared to controls. Disease severity variables were not significantly affected by any exposure after adjusting for PAH sub-group. In contrast to our hypothesis, that a greater exposure to exogenous sources of female sex hormones associates with PAH case status, we found similar rates of endogenous and exogenous sex hormone exposure between PAH patients and unmatched controls.
机译：肺动脉高压（PAH）是一种性疾病，出于未知的原因，影响女性比男性更多。雌激素，内源性和外源性的作用以及这种女性敏感性的生殖因素仍然很差。有强烈建议，性激素可能影响疾病的发展和进展。我们试图确定性激素暴露和生殖因素是否与PAH患者相比，与对照受试者相比，使用调查问卷和面试获取有关这些潜在风险因素的信息。我们进行了单中心无与伦比的案例控制研究。来自Vanderbilt肺动脉高血压研究队列和ResearchMatch.org的六百三十四名患有PAH的女性和男性，也没有PAH2突变，但没有PAH和132名健康人口对照。对问卷和护士带来的面试进行了获取有关性激素暴露和生殖因素的信息。在注册的患者包括疾病严重程度和合并症的患者中获得了额外的历史。分析对调查问卷的回应来描述本人的这些暴露，以及评估疾病严重变量和性激素曝光之间的关联。在PAH病例和对照之间确定终生雌激素暴露的生殖和内源性因素。与对照组相比，患有相关PAH的患者显着更可能是绝经后缺血。与对照相比，在患者中，有类似的“永远使用”和使用口服避孕药和激素替代治疗的持续时间。在调整PAH子组后，疾病严重变量不会受到任何暴露的显着影响。与我们的假设相比，与PAH病例状况的外源性荷尔蒙斯的外源性源，我们发现了类似的内源性和外源性激素暴露的外源性和外源性激素暴露率更大的暴露。

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