MENOPAUSE IS ASSOCIATED WITH LOWER LUNG FUNCTION IN WOMEN WITH AND WITHOUT HIV.

Abstract

Menopause accelerates lung function decline in women without HIV, but whether menopause modifies lung function in women with HIV (WWH) is unknown. Is menopause associated with lung function in women with and at-risk for HIV? Pulmonary function tests (1116 spirometry, 615 diffusing capacity for carbon monoxide [DLco]) collected from 2018-2019 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, 51-60) 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 to women in the same age group. Overall, 71% were WWH, 65% were Black, and the median age was 52 years; 36% and 31% reported current and former smoking, respectively, and 30% were premenopausal/early perimenopausal, 40% late perimenopausal, and 30% postmenopausal. There was no statistically significant association of HIV with FEV1 or FVC, but HIV was associated with lower DLco (p=0.004). After adjusting for demographic, clinical, and behavioral factors, we observed significant differences in lung function by menopausal phase in women aged 41-50, but not in those aged 51-60. Among those 41-50 years, when compared to pre/early perimenopause, women in late perimenopause had -109 mL (95%CI:-201,-16) and -125 mL (95%CI:-223,-28) and postmenopausal women had -310 mL (95%CI:-525,-96) and -307 mL (95%CI:-534,-80) lower mean FEV1 and FVC, respectively. Late perimenopausal women had -1.40 mL/min/mmHg (95%CI:-2.39,-0.41) lower mean DLco, but no clear evidence of difference in postmenopause. Menopausal phase is associated with lung function in women with and without HIV, even after accounting for age. Further research is needed to understand how estrogen depletion alters lung function.