![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
ABSTRACT
Background
This study aimed to investigate the association between sex hormones and the risk of pulmonary fibrosis by conducting a meta-analysis of previously published studies.
Methods
We executed a comprehensive search of the PubMed, Embase, Cochrane Library, and Web of Science databases to locate pertinent studies published up to April 2024. We included studies that reported the association between sex hormones and the risk of pulmonary fibrosis. Standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated using a random-effects model.
Results
A total of 10 articles, encompassing 1371 patients, were finally incorporated in this meta-analysis. Based on the evaluation of the included studies, it was observed that the levels of dehydroepiandrosterone sulfate (DHEA-S) (pooled SMD: −0.72, 95% CI: −1.21 to −0.24, p < 0.001), testosterone (pooled SMD: −1.25, CI: −2.39 and −0.11, p < 0.001) and estrogen (pooled SMD: −0.56, 95% CI: −0.96 to −0.15, p < 0.001) were significantly lower in patients with pulmonary fibrosis, whereas the levels of luteinizing hormone (LH) remained unaffected. Publication bias was ruled out through funnel plots.
Conclusion
This meta-analysis indicates that reduced levels of DHEA-S, testosterone, estrogen may serve as potential risk factors for pulmonary fibrosis. There is a pressing need for additional studies to confirm this association and explore the underlying biological mechanisms. Clinicians should recognize the potential influence of sex hormones in the etiology of pulmonary fibrosis and consider this aspect during the patient management process.
GRAPHICAL ABSTRACT
Abbreviations
| DHEA | = | Dehydroepiandrosterone |
| T | = | Testosterone |
| DHT | = | 5α-dihydrotestosterone |
| E1 | = | Estrone |
| E2 | = | Etradiol |
| LH | = | Luteinizing hormone |
| FSH | = | Follicle-stimulating hormone |
| PRLA | = | Prolactin Androstenedione |
| P | = | Progesterone |
| 17-OHP | = | 17-hydroxyprogesterone |
| AMH | = | Anti-mullerian hormone |
| SHBG | = | Sex hormone-binding globulin |
| 25(OH)D | = | 25-hydroxyvitamin D |
| ORs | = | Pooled odds ratios |
| CIs | = | Confidence intervals |
| PF | = | Pulmonary fibrosis |
| SARS-CoV-2 | = | Severe acute respiratory syndrome coronavirus 2 |
| COVID-19 | = | Coronavirus disease 2019 |
| IPF | = | Idiopathic pulmonary fibrosis |
| ILD | = | Interstitial lung disease |
| HRs | = | Hazard ratios |
| SMDs | = | Standardized mean differences |
| NOS | = | Newcastle-Ottawa Scale |
| non-RCT | = | Non-randomized controlled trial |
Declaration of financial/other relationships
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author contributions
Yunchang Yuan and Jingjing Zhang coordinated the study. Ying Chen had the idea for the study, along with Jiaxin Zhong. Ying Chen, Jiaxin Zhong, Zixin Cai, Zhenkun Xia and Bei Qing contributed to the study design, literature search, figures, statistical analysis, data synthesis of outcomes and drafted and edited the final paper. All authors critically revised the report. All members have confirmed and agreed to submit the manuscript.
Data availability statement
All data generated or analyzed during the present study are included in this published article.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/00325481.2024.2373683.