Park Boyoung, Kim Jeongseon
Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Korea.
Cancer Early Detection Branch, Division of Cancer Management Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Korea.
PLoS One. 2016 Jun 27;11(6):e0158177. doi: 10.1371/journal.pone.0158177. eCollection 2016.
This study addressed the associations between oral contraceptive (OC) use and obesity as measured by recording the body mass index (BMI) of premenopausal females, and possible interactions with micronutrient intake were considered. A group of 39,189 premenopausal females aged 35-59 were included in the analysis; they were in the Health Examinee cohort. Participant BMIs were calculated from anthropometric measurements, and females with a BMI≥25kg/m2 were considered obese. Individual OC use, age at first OC use, duration of OC use, nutrient intake, and other covariates were measured with a structured questionnaire. A multivariate logistic regression with an interaction term was applied to identify the odds ratio (OR) and 95% confidence intervals (CI) between OC use and obesity along with consideration of micronutrient intake interactions. OC use is associated with an increased risk of obesity (OR = 1.12, 95% CI = 1.04-1.20), and females who used OCs for more than 6 months over their lifetimes were more likely to be obese (OR = 1.15, 95% CI = 1.01-1.32) compared with those who used OCs for <6 months. There were interaction effects between phosphorus, potassium, vitamin A, vitamin B1, vitamin B2, niacin, vitamin C intake and total duration of OC use on being obesity (P-value<0.05). When stratified by micronutrient intake, the associations between total OC use duration and obesity were present only among those with calcium, phosphorus, potassium, vitamin A, B1, B2, C, niacin, and folate intakes below the recommended levels. Efforts to estimate nutrient intake and prevent micronutrient depletion with supplements or food should be considered by clinicians for females who take OC for a long period.
本研究通过记录绝经前女性的体重指数(BMI),探讨了口服避孕药(OC)使用与肥胖之间的关联,并考虑了与微量营养素摄入的可能相互作用。分析纳入了39189名年龄在35 - 59岁的绝经前女性,她们来自健康体检队列。参与者的BMI根据人体测量数据计算得出,BMI≥25kg/m²的女性被视为肥胖。通过结构化问卷测量个体的OC使用情况、首次使用OC的年龄、OC使用时长、营养素摄入及其他协变量。应用带有交互项的多因素逻辑回归来确定OC使用与肥胖之间的比值比(OR)和95%置信区间(CI),同时考虑微量营养素摄入的相互作用。使用OC与肥胖风险增加相关(OR = 1.12,95%CI = 1.04 - 1.20),与使用OC时间<6个月的女性相比,一生中使用OC超过6个月的女性更易肥胖(OR = 1.15,95%CI = 1.01 - 1.32)。磷、钾、维生素A、维生素B1、维生素B2、烟酸、维生素C摄入与OC使用总时长之间存在对肥胖的交互作用(P值<0.05)。按微量营养素摄入量分层时,OC使用总时长与肥胖之间的关联仅在钙、磷、钾、维生素A、B1、B2、C、烟酸和叶酸摄入量低于推荐水平的人群中存在。临床医生应考虑为长期服用OC的女性评估营养素摄入量,并通过补充剂或食物预防微量营养素缺乏。