title: Menopause Is Associated with Accelerated Lung Function Decline.
abstract: Menopause is associated with changes in sex hormones, which affect immunity, inflammation, and osteoporosis and may impair lung function. Lung function decline has not previously been investigated in relation to menopause.
  
  
  
  To study whether lung function decline, assessed by FVC and FEV1, is accelerated in women who undergo menopause.
  
  
  
  The population-based longitudinal European Community Respiratory Health Survey provided serum samples, spirometry, and questionnaire data about respiratory and reproductive health from three study waves (n = 1,438). We measured follicle-stimulating hormone and luteinizing hormone and added information on menstrual patterns to determine menopausal status using latent class analysis. Associations with lung function decline were investigated using linear mixed effects models, adjusting for age, height, weight, pack-years, current smoking, age at completed full-time education, spirometer, and including study center as random effect.
  
  
  
  Menopausal status was associated with accelerated lung function decline. The adjusted mean FVC decline was increased by -10.2 ml/yr (95% confidence interval [CI], -13.1 to -7.2) in transitional women and -12.5 ml/yr (95% CI, -16.2 to -8.9) in post-menopausal women, compared with women menstruating regularly. The adjusted mean FEV1decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) in post-menopausal women.
  
  
  
  Lung function declined more rapidly among transitional and post-menopausal women, in particular for FVC, beyond the expected age change. Clinicians should be aware that respiratory health often deteriorates during reproductive aging.
authors.affiliation: 1 Department of Clinical Science.|2 Core Facility for Metabolomics.
authors.forename: Kai
authors.initials: K
authors.lastname: Triebner
authors.affiliation: 3 Pathophysiology and Epidemiology of Respiratory Diseases and.
authors.forename: Bobette
authors.initials: B
authors.lastname: Matulonga
authors.affiliation: 1 Department of Clinical Science.|4 Department of Global Public Health and Primary Care.
authors.forename: Ane
authors.initials: A
authors.lastname: Johannessen
authors.affiliation: 2 Core Facility for Metabolomics.
authors.forename: Sandra
authors.initials: S
authors.lastname: Suske
authors.affiliation: 5 Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
authors.forename: Bryndís
authors.initials: B
authors.lastname: Benediktsdóttir
authors.affiliation: 6 Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Demoly
authors.affiliation: 7 Allergy and Lung Health Unit, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia.
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: 8 Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Franklin
authors.affiliation: 9 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Barcelona, Spain.|10 Universitat Pompeu Fabra, Barcelona, Spain.|11 Centro de Investigación Biomedica en Red (CIBER), Epidemiología y Salud Pública, Barcelona, Spain.
authors.forename: Judith
authors.initials: J
authors.lastname: Garcia-Aymerich
authors.affiliation: 12 Department of Pneumology, Hospital San Agustin de Aviles, Oviedo, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Gullón Blanco
authors.affiliation: 13 Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University Munich, Munich, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: 14 Department of Occupational and Environmental Medicine, University of Gothenburg, Göteborg, Sweden.
authors.forename: Mathias
authors.initials: M
authors.lastname: Holm
authors.affiliation: 15 Department of Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, United Kingdom.
authors.forename: Debbie
authors.initials: D
authors.lastname: Jarvis
authors.affiliation: 16 Department of Lung Medicine, Tartu University Clinic, Tartu, Estonia.
authors.forename: Rain
authors.initials: R
authors.lastname: Jõgi
authors.affiliation: 17 Department of Medical Sciences, Lung, Allergy, and Sleep Research, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.affiliation: 18 Servicio de Neumología, Servicio de Salud de Castilla - La Mancha, Albacete, Spain.
authors.forename: Jesús Martínez
authors.initials: JM
authors.lastname: Moratalla Rovira
authors.affiliation: 19 Epidemiologia, Salud Pública, Dep. Salud, Gobierno Vasco, Hospital, Galdakao, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Muniozguren Agirre
authors.affiliation: 20 Pneumologie Pédiatrique, Antenne Pédiatrique du CIC, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pin
authors.affiliation: 21 Swiss Tropical and Public Health Institute, Basel, Switzerland.|22 Department of Public Health, University of Basel, Basel, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
authors.affiliation: 23 Department of Electronic Engineering, University of Ireland, Maynooth, Ireland.
authors.forename: Luca
authors.initials: L
authors.lastname: Puggini
authors.affiliation: 24 U1219, Bordeaux Population Health Research Center, Bordeaux, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Raherison
authors.affiliation: 25 Department of Nursing, University of Huelva, Huelva, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Sánchez-Ramos
authors.affiliation: 26 Department of Public Health, Aarhus University, Aarhus, Denmark.|27 National Research Center for the Working Environment, Copenhagen, Denmark.
authors.forename: Vivi
authors.initials: V
authors.lastname: Schlünssen
authors.affiliation: 9 ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona Biomedical Research Park, Barcelona, Spain.|10 Universitat Pompeu Fabra, Barcelona, Spain.|11 Centro de Investigación Biomedica en Red (CIBER), Epidemiología y Salud Pública, Barcelona, Spain.|28 Hospital del Mar Medical Research Institute, Barcelona, Spain; and.
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
authors.affiliation: 30 Centre for International Health, and.|29 Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Svanes
authors.affiliation: 1 Department of Clinical Science.|2 Core Facility for Metabolomics.
authors.forename: Steinar
authors.initials: S
authors.lastname: Hustad
authors.affiliation: 31 Team of Epidemiology, French National Institute of Health and Medical Research (INSERM), UMR1152, Paris, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Leynaert
authors.affiliation: 1 Department of Clinical Science.|32 Department of Gynecology and Obstetrics, University of Bergen, Bergen, Norway.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gómez Real
mesh_terms: D000328:Adult; D000367:Age Factors; D000375:Aging / Q000502:physiology; D005060:Europe; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D012129:Respiratory Function Tests / Q000706:statistics & numerical data; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology*
keywords: latent class analysis; lung function decline; menopause; reproductive aging; sex hormones