Mahalingaiah Shruthi, Sun Fangui, Cheng J Jojo, Chow Erika T, Lunetta Kathryn L, Murabito Joanne M
Department of Obstetrics and Gynecology, Boston University School of Medicine, 85 East Concord Street, Boston, MA 02118 USA.
Department of Epidemiology, Boston University School of Public Health, Talbot 3E, 715 Albany Street, Boston, MA 02118 USA.
Fertil Res Pract. 2017 Apr 11;3:7. doi: 10.1186/s40738-017-0034-0. eCollection 2017.
Amongst women with certain types of ovulatory disorder infertility, the studies are conflicting whether there is an increased risk of long-term cardiovascular disease risk. This paper evaluates the associations of several CVD risk factors among Framingham women with self-reported infertility.
Women who completed the Framingham Heart Study Third Generation and Omni Cohort 2 Exam 2 (2008-2011), and reported on past history of infertility and current cardiovascular disease status were included in this cross-sectional study. Directly measured CVD risk factors were: resting blood pressure, fasting lipid levels, fasting blood glucose, waist circumference, and body mass index (BMI). Multivariable models adjusted for age, smoking, physical activity, and cohort. Generalized estimating equations adjusted for family correlations. We performed sensitivity analyses to determine whether the association between infertility and CVD risk factors is modified by menopausal status and menstrual cycle length.
Comparing women who self-reported infertility to those who did not, there was an average increase in BMI (β = 1.03 kg/m, 95% CI: 0.18, 1.89), waist circumference (β = 3.08 in., 95% CI: 1.06, 5.09), triglycerides (β = 4.47 mg/dl, 95% CI:-1.54, 10.49), and a decrease in HDL cholesterol (β = -1.60 mg/dl, 95% CI: -3.76, 0.56). We estimated that infertile premenopausal women have an increased odds of obesity (BMI ≥ 30 kg/m) (OR = 1.56, 95% CI: 1.11, 4.49) and diabetes (OR = 1.96, 95% CI: 0.86, 4.49).
BMI and waist circumference were the most strongly correlated CVD risk factors amongst women reporting a history of infertility.
在患有某些类型排卵障碍性不孕症的女性中,关于长期心血管疾病风险是否增加的研究结果相互矛盾。本文评估了弗雷明汉有自我报告不孕症的女性中几种心血管疾病风险因素之间的关联。
完成弗雷明汉心脏研究第三代和全队列2检查2(2008 - 2011年),并报告过去不孕症病史和当前心血管疾病状况的女性被纳入这项横断面研究。直接测量的心血管疾病风险因素包括:静息血压、空腹血脂水平、空腹血糖、腰围和体重指数(BMI)。多变量模型对年龄、吸烟、身体活动和队列进行了调整。广义估计方程对家庭相关性进行了调整。我们进行了敏感性分析,以确定不孕症与心血管疾病风险因素之间的关联是否因绝经状态和月经周期长度而改变。
将自我报告有不孕症的女性与未报告的女性进行比较,BMI平均增加(β = 1.03kg/m,95%可信区间:0.18,1.89),腰围增加(β = 3.08英寸,95%可信区间:1.06,5.09),甘油三酯增加(β = 4.47mg/dl,95%可信区间:-1.54,10.49),高密度脂蛋白胆固醇降低(β = -1.60mg/dl,95%可信区间:-3.76,0.56)。我们估计,未绝经的不孕女性肥胖(BMI≥30kg/m)的几率增加(比值比 = 1.56,95%可信区间:1.11,4.49),患糖尿病的几率增加(比值比 = 1.96,95%可信区间:0.86,4.49)。
在报告有不孕症病史的女性中,BMI和腰围是与心血管疾病风险因素相关性最强的因素。