The Association of Menopause With Lung Function in Women With and Without HIV
Rebecca A Abelman1, Fan Xia1, M Bradley Drummond2
1Departments of Medicine, and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA.
Background:
Menopause accelerates lung function decline in women without HIV, but whether menopause modifies lung function in women with HIV (WWH) is unknown.
Research Question:
Is menopause associated with lung function in WWH and women at risk for HIV?
Study Design And Methods:
Pulmonary function tests (spirometry: n = 1,116; diffusing capacity for carbon monoxide [Dlco]: n = 615) collected from 2018 to 2019 in 1,206 participants from the Women's Interagency HIV Study were included. In this cross-sectional analysis, women were categorized into groups defined by age (41-50 and 51-60 years of age) and by menopausal phase as determined by anti-Müllerian hormone, a biomarker of ovarian reserve. Linear regression models determined the differences in mean FEV1, FVC, and Dlco by menopausal phase compared with women in the same age group.
Results:
Overall, 71% were WWH, 65% were Black, and the median age was 52 years. Of the participants, 36% and 31% reported current and former smoking, respectively. A total of 30% were premenopausal/early perimenopausal, 40% were late perimenopausal, and 30% were postmenopausal. There was no statistically significant association of HIV with FEV1 or FVC, but HIV was associated with lower Dlco (P = .004). After adjusting for demographic, clinical, and behavioral factors, we observed significant differences in lung function by menopausal phase in women 41 to 50 years of age, but not in those 51 to 60 years of age. Among those 41 to 50 years of age, when compared with premenopause/early perimenopause, women in late perimenopause had -109 mL (95% CI, -201 to -16) and -125 mL (95% CI, -223 to -28) and postmenopausal women had -310 mL (95% CI, -525 to -96) and -307 mL (95% CI, -534 to -80) lower mean FEV1 and FVC, respectively. Late perimenopausal women had -1.40 mL/min/mm Hg (95% CI, -2.39 to -0.41) lower mean Dlco, but no clear evidence of difference in postmenopause.
Interpretation:
Our results show that menopausal phase is associated with lung function in WWH and women without HIV, even after accounting for age. Further research is needed to understand how estrogen depletion alters lung function.
Related Concept Videos
01:28Menopause
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:19Chronic Obstructive Pulmonary Disease IV: Clinical Manifestations
01:23Chronic Obstructive Pulmonary Disease II: Emphysema
01:20Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...