Female Reproductive Factors and Incidence of NTM Pulmonary Disease Among Postmenopausal Women in Korea

초록

RATIONALE: Although female sex hormone is suggested to be associated with non-tuberculous mycobacterial pulmonarydisease (NTM-PD), the effects of female reproductive factors on the risk of NTM-PD in postmenopausal women have not beenwell studied.METHODS: This population-based cohort study consisted of 1,400,095 postmenopausal women without previousNTM-PD participating in the 2009 national health screening exam in South Korea. The cohort was followed until the date ofincident NTM-PD, death, or December 2018. We evaluated whether female reproductive factors (age at menarche, age atmenopause, parity, oral contraceptive [OC] use, or hormone replacement therapy [HRT]) were associated with the incidence ofNTM-PD.RESULTS: During a median of 8.2 years of follow-up, 0.1% (1,818/1,400,095) developed NTM-PD, with an incidencerate of 0.15/1000 person-years. In the multivariable Cox regression model, the duration of HRT showed a significant positiverelationship with incident NTM-PD (adjusted hazard ratio [95% confidence interval]; 1.32 [1.34–1.53] in HRT for < 2 years, 1.33[1.07–1.65] in 2–5 years, and 1.77 [1.42–2.20] in ≥ 5 years). However, there were no significant associations between otherreproductive factors (e.g., age at menarche, age at menopause, parity, and OC use) and the risk of NTM-PD.CONCLUSION: Ourstudy suggests longer HRT may increase the risk of NTM-PD in postmenopausal women.