Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Am J Hypertens. 2018 Apr 13;31(5):615-621. doi: 10.1093/ajh/hpx219.
Little is known about the relationship between breastfeeding and hypertension. We performed this study to identify whether breastfeeding itself influenced maternal hypertension and whether degree of obesity or insulin sensitivity would contribute to the relationship between breastfeeding and hypertension in postmenopausal women.
Our study population comprised 3,119 nonsmoking postmenopausal women aged 50 years or above in the 2010-2011 Korea National Health and Nutrition Examination Survey. We performed logistic regression analyses to examine the relationship between breastfeeding and hypertension and mediation analyses to examine the contributions of obesity and insulin sensitivity to the breastfeeding-hypertension relationship.
The odds ratios, with 95% confidence intervals, for hypertension among the highest quintile of number of breastfed children (5-11) and the highest quintile of duration of breastfeeding (96-324 months) were 0.49 (0.31-0.75) and 0.55 (0.37-0.82), respectively, compared to each of lowest quintile groups. The population attributable fractions of hypertension caused by breastfeeding 3 or fewer children and breastfeeding for 56 months or less were 10.2% (P < 0.001) and 6.5% (P = 0.017), respectively. In the mediation analysis, unexpectedly, increased insulin resistance significantly attenuated the protective effect on hypertension of having breastfed more children; additionally, greater obesity and insulin resistance significantly attenuated the protective effects on hypertension of having breastfed for longer.
More children breastfed and longer duration of breastfeeding were associated with lower risk of hypertension in postmenopausal women, and degree of obesity and insulin resistance moderated the breastfeeding-hypertension association.
关于母乳喂养与高血压之间的关系知之甚少。我们进行这项研究是为了确定母乳喂养本身是否会影响产妇高血压，以及肥胖程度或胰岛素敏感性是否会影响母乳喂养与绝经后妇女高血压之间的关系。
我们的研究人群包括 2010-2011 年韩国国家健康和营养检查调查中年龄在 50 岁及以上的 3119 名不吸烟的绝经后妇女。我们进行了逻辑回归分析，以检查母乳喂养与高血压之间的关系，并进行了中介分析，以检查肥胖和胰岛素敏感性对母乳喂养与高血压关系的贡献。
与最低五分位数组相比，最高五分位数组（5-11 个）和最高五分位数组（96-324 个月）的母乳喂养儿童数量和母乳喂养时间的比值比（95%置信区间）分别为 0.49（0.31-0.75）和 0.55（0.37-0.82）。母乳喂养 3 个或更少儿童和母乳喂养 56 个月或更少导致高血压的人群归因分数分别为 10.2%（P <0.001）和 6.5%（P=0.017）。在中介分析中，出乎意料的是，胰岛素抵抗的增加显著减弱了母乳喂养更多儿童对高血压的保护作用；此外，肥胖程度和胰岛素抵抗的增加显著减弱了母乳喂养时间更长对高血压的保护作用。
母乳喂养的儿童更多和母乳喂养时间更长与绝经后妇女患高血压的风险较低相关，肥胖程度和胰岛素敏感性调节了母乳喂养与高血压之间的关系。
