Sarcoidosis incidence peaks in women between 50 and 60 years old, which coincides with menopause, suggesting that certain sex hormones, mainly estrogen, may play a role in disease development. We investigated whether menopausal hormone therapy (MHT) was associated with sarcoidosis risk in women and whether the risk varied by treatment type. We performed a nested case–control study (2007–2020) including incident sarcoidosis cases from the Swedish National Patient Register (n = 2593) and matched (1:10) to general population controls (n = 20,003) on birth year, county, and living in Sweden at the time of sarcoidosis diagnosis. Dispensations of MHT were obtained from the Swedish Prescribed Drug Register before sarcoidosis diagnosis/matching. Adjusted odds ratios (aOR) of sarcoidosis were estimated using conditional logistic regression. Ever MHT use was associated with a 25% higher risk of sarcoidosis compared with never use (aOR 1.25, 95% CI 1.13–1.38). When MHT type and route of administration were considered together, systemic estrogen was associated with the highest risk of sarcoidosis (aOR 1.51, 95% CI 1.23–1.85), followed by local estrogen (aOR 1.25, 95% CI 1.11–1.42), while systemic estrogen-progestogen combined was associated with the lowest risk compared to never users (aOR 1.12, 95% CI 0.96–1.31). The aOR of sarcoidosis did not differ greatly by duration of MHT use. Our findings suggest that a history of MHT use is associated with increased risk of sarcoidosis, with women receiving estrogen administered systemically having the highest risk.

结节病的发病率在 50 岁至 60 岁之间达到高峰，此时恰逢更年期，这表明某些性激素（主要是雌激素）可能在疾病的发展中发挥作用。我们调查了更年期激素治疗（MHT）是否与女性结节病风险相关，以及该风险是否因治疗类型而异。我们进行了一项巢式病例对照研究（2007-2020），包括来自瑞典国家患者登记处的结节病病例（n = 2593），并在出生年份、县、县、地区与一般人群对照（n = 20,003）进行匹配（1:10）。诊断结节病时居住在瑞典。在结节病诊断/匹配之前，MHT 的处方是从瑞典处方药登记处获得的。使用条件逻辑回归估计结节病的调整优势比（aOR）。与从未使用过相比，曾经使用过 MHT 的结节病风险增加 25%（aOR 1.25，95% CI 1.13–1.38）。当综合考虑 MHT 类型和给药途径时，全身雌激素与结节病风险最高相关（aOR 1.51，95% CI 1.23–1.85），其次是局部雌激素（aOR 1.25，95% CI 1.11–1.42），而与从未使用者相比，全身雌激素-孕激素组合的风险最低（aOR 1.12，95% CI 0.96-1.31）。结节病的 aOR 因 MHT 使用时间的不同而没有很大差异。我们的研究结果表明，MHT 使用史与结节病风险增加相关，其中接受全身雌激素治疗的女性风险最高。