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首页> 外文期刊>Annals of epidemiology >Menopausal hormone therapy and sleep-disordered breathing: evidence for a healthy user bias
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Menopausal hormone therapy and sleep-disordered breathing: evidence for a healthy user bias

机译：更年期激素疗法和睡眠呼吸障碍：健康使用者偏见的证据

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Purpose: Observational studies suggest that menopausal hormone therapy protects against sleep-disordered breathing, but such findings may be biased by a "healthy user effect." When the Women's Health Initiative Study reported in 2002 that estrogen-progestin therapy increases heart disease risk, many women discontinued hormone therapy. We investigate healthy user bias in the association of hormone therapy with sleep-disordered breathing in the Sleep in Midlife Women Study. Methods: A total of 228 women aged 38 to 62 years were recruited from the Wisconsin Sleep Cohort Study. They underwent polysomnography to measure apnea-hypopnea index, at home semiannually from 1997 to 2006, and in the sleep laboratory every four years (n = 1828 studies). Hormone therapy was recorded monthly. Linear models with empirical standard errors regressed logarithm of apnea-hypopnea index on hormone use with a pre- or post-July 2002 interaction, adjusting for menopause and age. Results: The association of hormone therapy and sleep-disordered breathing was heterogeneous (P < .01); apnea-hypopnea index among users was 15% lower in the early period (95% confidence interval, -27% to -1%), but similar to nonusers in the late.
机译：目的：观察性研究表明，更年期激素疗法可防止睡眠呼吸障碍，但这种发现可能会因“健康的使用者效应”而产生偏差。 2002年《妇女健康倡议研究》报告说，雌激素-孕激素疗法会增加患心脏病的风险，许多妇女因此停止了激素疗法。我们在《中年妇女睡眠研究》中调查了激素治疗与睡眠呼吸障碍之间健康的用户偏见。方法：从威斯康星州睡眠队列研究中招募了228名年龄在38至62岁之间的女性。他们于1997年至2006年每半年每隔四年，在睡眠实验室每隔四年进行多导睡眠监测以测量呼吸暂停低通气指数（n = 1828研究）。每月记录激素治疗。具有经验标准误的线性模型在2002年7月之前或之后的交互作用下，对激素使用的呼吸暂停低通气指数进行了对数回归，并根据更年期和年龄进行了调整。结果：激素疗法与睡眠呼吸障碍之间的关联是异质性的（P <.01）;使用者中的呼吸暂停低通气指数在早期阶段降低了15％（95％置信区间为-27％至-1％），但在后期却与非使用者类似。

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