美国西班牙裔/拉丁裔女性的生育情况与代谢综合征的组成部分：来自西班牙裔社区健康研究/拉丁裔研究的结果。
Parity and Components of the Metabolic Syndrome Among US Hispanic/Latina Women: Results From the Hispanic Community Health Study/Study of Latinos.
作者信息
Vladutiu Catherine J, Siega-Riz Anna Maria, Sotres-Alvarez Daniela, Stuebe Alison M, Ni Andy, Tabb Karen M, Gallo Linda C, Potter JoNell E, Heiss Gerardo
机构信息
From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.).
出版信息
Circ Cardiovasc Qual Outcomes. 2016 Feb;9(2 Suppl 1):S62-9. doi: 10.1161/CIRCOUTCOMES.115.002464.
BACKGROUND
Physiological adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life.
METHODS AND RESULTS
The association between parity and metabolic syndrome was examined among 7467 Hispanic/Latina women of diverse backgrounds, aged 18 to 74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008 to 2011. Metabolic syndrome components were defined according to American Heart Association/National Heart, Lung, and Blood Institute criteria and included abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and elevated fasting glucose. Logistic regression models estimated odds ratios (ORs) adjusting for sociodemographic, behavioral, and reproductive characteristics. At HCHS/SOL baseline, women reported none (21.1%), 1 (19.9%), 2 (25.7%), 3 (18.6%), 4 (8.8%), and ≥ 5 (5.9%) live births. When compared with women with 1 birth, those with 4 births had the highest odds of abdominal obesity (OR, 2.0; 95% confidence interval, 1.5-2.8) and overall metabolic syndrome (OR, 1.4; 95% confidence interval, 1.0-2.0) and those with ≥ 5 births had the highest odds of low high-density lipoprotein cholesterol (OR, 1.5; 95% confidence interval, 1.2-2.0) and elevated fasting glucose (OR, 1.6; 95% confidence interval, 1.1-2.4), after adjusting for age, background, education, marital status, income, nativity, smoking, physical activity, menopause, oral contraceptive use, hormone therapy, and field center. Further adjustment for percent body fat attenuated these associations. No associations were observed between parity and elevated triglycerides or high blood pressure.
CONCLUSIONS
Higher parity is associated with an increased prevalence of selected components of the metabolic syndrome among Hispanic/Latina women in the US. High parity among Hispanics/Latinas with a high prevalence of abdominal obesity suggests high risk for metabolic dysregulation.
背景
连续妊娠期间发生的生理适应性变化可能会增加日后不良心血管健康结局的风险。
方法与结果
在7467名年龄在18至74岁、背景各异的西班牙裔/拉丁裔女性中研究了产次与代谢综合征之间的关联，这些女性在2008年至2011年期间参与了西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）。代谢综合征的组成部分根据美国心脏协会/美国国立心肺血液研究所的标准定义，包括腹型肥胖、甘油三酯升高、高密度脂蛋白胆固醇降低、高血压和空腹血糖升高。逻辑回归模型估计了经社会人口统计学、行为和生殖特征调整后的比值比（OR）。在HCHS/SOL基线时，女性报告的活产数分别为无（21.1%）、1次（19.9%）、2次（25.7%）、3次（18.6%）、4次（8.8%）和≥5次（5.9%）。与生育1次的女性相比，生育4次的女性腹型肥胖（OR，2.0；95%置信区间，1.5 - 2.8）和总体代谢综合征（OR，1.4；95%置信区间，1.0 - 2.0）的几率最高，生育≥5次的女性高密度脂蛋白胆固醇降低（OR，1.5；95%置信区间，1.2 - 2.0）和空腹血糖升高（OR，1.6；95%置信区间，1.1 - 2.4）的几率最高，这些都是在对年龄、背景、教育程度、婚姻状况、收入、出生地、吸烟、身体活动、绝经、口服避孕药使用、激素治疗和研究中心进行调整之后。进一步对体脂百分比进行调整减弱了这些关联。未观察到产次与甘油三酯升高或高血压之间存在关联。
结论
在美国西班牙裔/拉丁裔女性中，较高的产次与代谢综合征某些组成部分的患病率增加有关。腹型肥胖患病率较高的西班牙裔/拉丁裔女性中产次较高表明代谢失调风险较高。
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