Abstract
Background: The role of sex hormones in asthma pathogenesis is unclear.
Methods: In a cross-sectional analysis of 9,290 adults (18-79 years old) with data on serum total testosterone and serum estradiol in the 2013-2016 U.S. National Health and Nutrition Examination Survey, we examined the relation between sex hormones and asthma or asthma exacerbations using separate logistic regression models for each gender, adjusting for age, race/ethnicity, income, body mass index, family history of asthma, second-hand smoke, and smoking status.
Results: In women, higher testosterone or estradiol levels were associated with lower odds of asthma (OR for quartiles 2-4 vs. 1 [lowest]: 0.65 [95% CI=0.50-0.85] for testosterone, and 0.72 [95% CI=0.53-0.98] for estradiol). Given a significant interaction between obesity and sex hormones on asthma, as well as hormonal changes in menopause (MP), we conducted an analysis stratified by obesity and MP. In this analysis, hormonal levels above the first quartile were associated with lower odds of asthma in obese post-MP women (OR: 0.47 [95% CI=0.28-0.80] for testosterone; and 0.47 [95% CI=0.30-0.74] for estradiol), but not in pre-MP women or in lean post-MP women. An estradiol level above the first quartile was also associated with lower odds of exacerbations in asthmatic women (OR=0.41 [95% CI=0.22-0.78]). Sex steroid hormones were not associated with asthma or asthma exacerbations in men.
Conclusions: In a sample of U.S. adults, a high estradiol or testosterone level was linked to lower odds of asthma in post-PM obese females. A high estradiol was also associated with fewer asthma exacerbations in females.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2773.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019