Baker IDI Heart & Diabetes Institute, Melbourne, Australia.
Stroke. 2010 Jul;41(7):1332-7. doi: 10.1161/STROKEAHA.110.579219. Epub 2010 Jun 10.
Parity is associated with the risk of clinical cardiovascular events and the severity of preclinical atherosclerosis in older subjects. We sought to determine whether childbearing is associated with concurrent changes in cardiovascular risk factors and the progression of carotid intima-media thickness.
We examined the association between the number of children born during a 6-year period and concurrent changes in cardiovascular risk factors and progression of carotid intima-media thickness in men and women of reproductive age from the Cardiovascular Risk in Young Finns study. Complete data for parity and carotid intima-media thickness were available for 1786 subjects (1005 females, 781 males).
For females, childbirth during the 6-year follow-up was associated with concurrent reductions in high-density lipoprotein cholesterol (P(trend)<0.0001), apolipoprotein A-I (P(trend)<0.0001), and apolipoprotein B (P(trend)=0.01); a redistribution of adiposity to abdominal deposits; and increased progression of carotid intima-media thickness (7.5+/-3.2 mum/birth [mean+/-SEM], P=0.02). The association of childbirth with carotid intima-media thickness progression was not greatly modified by adjustment for concurrent changes in cardiovascular risk factors (fully adjusted: P=0.05). This association was significantly stronger in females than males (P(heterogeneity)=0.001), who served as a control group exposed to the social and lifestyle influences of child-rearing but not the biological influences of childbearing.
The progression of carotid atherosclerosis over a 6-year period is increased in females who gave birth during the same period, independent of traditional risk factors. Mechanisms that underlie this observation possibly include parity-induced changes in nontraditional risk factors or an acute influence of pregnancy itself.
在老年人群中，生育子女的数量与临床心血管事件的风险以及临床前动脉粥样硬化的严重程度相关。我们试图确定生育子女是否与心血管危险因素的同期变化及颈动脉内膜中层厚度的进展相关。
我们检测了在芬兰年轻人心血管风险研究中，生育子女数量与同期心血管危险因素变化及颈动脉内膜中层厚度进展之间的相关性，研究对象为处于生育年龄的男性和女性（共 1786 例，女性 1005 例，男性 781 例）。
对于女性，6 年随访期间的生育与高密度脂蛋白胆固醇（P(trend)<0.0001）、载脂蛋白 A-I（P(trend)<0.0001）和载脂蛋白 B（P(trend)=0.01）的同期降低相关；体脂重新分布至腹部沉积；颈动脉内膜中层厚度的进展加快（每生育一次增加 7.5+/-3.2 微米[平均值+/-SEM]，P=0.02）。生育与颈动脉内膜中层厚度进展之间的相关性，在调整同期心血管危险因素变化后并未发生较大改变（完全调整：P=0.05）。该相关性在女性中明显强于男性（P(异质性)=0.001），后者作为对照组，不仅暴露于养育子女的社会和生活方式影响下，还受到生育的生物学影响。
在同期生育的女性中，颈动脉粥样硬化的进展在 6 年内会增加，这与传统危险因素无关。这种观察结果的潜在机制可能包括生育引起的非传统危险因素的变化，或妊娠本身的急性影响。
