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Association Between Hormone Replacement Therapy (HRT) Use and Radiographic Emphysema Risk

Nnadi, Chimeremma (2011) Association Between Hormone Replacement Therapy (HRT) Use and Radiographic Emphysema Risk. Master's Thesis, University of Pittsburgh.

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    Abstract

    Emphysema, a form of chronic obstructive pulmonary disease (COPD) is a disease of significant public health importance that remains a major cause of morbidity and mortality within the US population and elsewhere in the industrialized world. An emerging body of literature appears to suggest gender differences in susceptibility to emphysema, with women showing significantly less emphysematous changes on high resolution Computed Tomography radiography compared to men. A pertinent but yet to be addressed question in the literature however, is whether these apparent differences in emphysematous structural lung disease result from differential exposures and or lifestyle choices on the one hand, or if on the other hand, these gender differences in CT-emphysema are related to certain biological mechanisms such as female hormonal influences or genetic differences in toxin metabolism. The present study evaluated differences in CT-emphysema status among 1834 women with different hormone replacement therapy (HRT) exposure profiles. In an unadjusted generalized logistic regression model, current use of HRT was statistically significantly associated with a 38% reduction in the risk of moderate to severe CT-emphysema, OR 0.62 (95% CI=0.39-0.99). After adjusting for the effects of age and smoking dose intensity, current HRT-users had a 34% reduction in the risk of mild to moderate CT-emphysema compared to never-users. Although this effect is quite sizable, it was marginally statistically insignificant, OR=0.66 (95% CI=0.41-1.07). We conclude that current use of hormone replacement therapy may be associated with a lower risk of moderate to severe CT-emphysema.

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    Details

    Item Type: University of Pittsburgh ETD
    ETD Committee:
    ETD Committee TypeCommittee MemberEmail
    Committee ChairWeissfeld, Joel Ljwepid@pitt.edu
    Committee MemberSiegfried, Jill Mjsiegfr@pitt.edu
    Committee MemberLand, Stephanie Rland@nsabp.pitt.edu
    Title: Association Between Hormone Replacement Therapy (HRT) Use and Radiographic Emphysema Risk
    Status: Unpublished
    Abstract: Emphysema, a form of chronic obstructive pulmonary disease (COPD) is a disease of significant public health importance that remains a major cause of morbidity and mortality within the US population and elsewhere in the industrialized world. An emerging body of literature appears to suggest gender differences in susceptibility to emphysema, with women showing significantly less emphysematous changes on high resolution Computed Tomography radiography compared to men. A pertinent but yet to be addressed question in the literature however, is whether these apparent differences in emphysematous structural lung disease result from differential exposures and or lifestyle choices on the one hand, or if on the other hand, these gender differences in CT-emphysema are related to certain biological mechanisms such as female hormonal influences or genetic differences in toxin metabolism. The present study evaluated differences in CT-emphysema status among 1834 women with different hormone replacement therapy (HRT) exposure profiles. In an unadjusted generalized logistic regression model, current use of HRT was statistically significantly associated with a 38% reduction in the risk of moderate to severe CT-emphysema, OR 0.62 (95% CI=0.39-0.99). After adjusting for the effects of age and smoking dose intensity, current HRT-users had a 34% reduction in the risk of mild to moderate CT-emphysema compared to never-users. Although this effect is quite sizable, it was marginally statistically insignificant, OR=0.66 (95% CI=0.41-1.07). We conclude that current use of hormone replacement therapy may be associated with a lower risk of moderate to severe CT-emphysema.
    Date: 29 June 2011
    Date Type: Completion
    Defense Date: 01 April 2011
    Approval Date: 29 June 2011
    Submission Date: 07 April 2011
    Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
    Patent pending: No
    Institution: University of Pittsburgh
    Thesis Type: Master's Thesis
    Refereed: Yes
    Degree: MS - Master of Science
    URN: etd-04072011-143321
    Uncontrolled Keywords: CT-EMPHYSEMA; EMPHYSEMA; ESTROGEN; FEMALE REPRODUCTIVE HORMONES; GENDER DIFFERENCES; HORMONE REPLACEMENT THERAPY; HRT
    Schools and Programs: Graduate School of Public Health > Epidemiology
    Date Deposited: 10 Nov 2011 14:35
    Last Modified: 25 Apr 2012 11:13
    Other ID: http://etd.library.pitt.edu/ETD/available/etd-04072011-143321/, etd-04072011-143321

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