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自述不孕、代谢功能障碍和心血管事件:美国女性的横断面分析。

Self-reported infertility, metabolic dysfunction, and cardiovascular events: a cross-sectional analysis among U.S. women.

机构信息

Maternal & Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland.

Maternal & Child Health Program, Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland; Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, Maryland; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.

出版信息

Fertil Steril. 2019 Jan;111(1):138-146. doi: 10.1016/j.fertnstert.2018.10.009. Epub 2018 Nov 17.

Abstract

OBJECTIVE

To explore associations between infertility and metabolic syndrome, and cardiovascular events. Infertility is increasingly a public health issue, with emerging links to chronic disease. Existing literature on infertility focuses primarily on known causes, which likely excludes a substantial number of women for whom there is no known cause or formal diagnosis.

DESIGN/SETTING: We conducted a cross-sectional analysis examining the association between self-reported infertility (i.e., ever experiencing inability to conceive after 12 months of trying to become pregnant) and metabolic syndrome and cardiovascular events (i.e., congestive heart failure, coronary heart disease, heart attack, or stroke). Data were analyzed using multivariate logistic regression.

PATIENT(S): A total of 744 U.S. women, 20-59 years of age, from the National Health and Nutrition Examination Survey (2013-2014), participated in the study. Among them, 15.7% reported ever experiencing infertility, 27.6% met the definition of metabolic syndrome, and 2.84% reported ever having a cardiovascular event.

INTERVENTION(S): N/A.

MAIN OUTCOME MEASURE(S): Metabolic syndrome and cardiovascular events.

RESULTS

Compared to women who had never experienced infertility, women who reported infertility had a 1.79 (95% confidence interval [CI] 1.04, 3.08) higher odds of reporting symptoms of metabolic syndrome and 1.83 (95% CI 1.15, 2.89) times higher odds of having experienced a cardiovascular event. Furthermore, women with self-reported infertility had a 71% higher odds of reporting a cardiovascular event after controlling for metabolic syndrome (95% CI 1.01, 3.00).

CONCLUSIONS

Our results suggest that among U.S. women, the experience of infertility at any point in a woman's reproductive window may be associated with later-life cardiovascular health.

摘要

目的

探讨不孕与代谢综合征和心血管事件之间的关联。不孕已成为一个日益严重的公共卫生问题,且与慢性病之间存在新的关联。现有关于不孕的文献主要侧重于已知病因,这可能排除了相当一部分病因不明或尚未确诊的女性。

设计/设置:我们进行了一项横断面分析,研究了自我报告的不孕(即尝试怀孕 12 个月后仍无法受孕)与代谢综合征和心血管事件(即充血性心力衰竭、冠心病、心脏病发作或中风)之间的关系。数据分析采用多变量逻辑回归。

患者

共有 744 名年龄在 20-59 岁的美国女性参加了本次研究,她们来自 2013-2014 年的全国健康和营养调查。其中,15.7%的女性报告曾经历过不孕,27.6%的女性符合代谢综合征的定义,2.84%的女性报告曾有过心血管事件。

干预措施

无。

主要观察指标

代谢综合征和心血管事件。

结果

与从未经历过不孕的女性相比,报告不孕的女性患代谢综合征的几率高 1.79 倍(95%置信区间[CI] 1.04,3.08),经历心血管事件的几率高 1.83 倍(95% CI 1.15,2.89)。此外,在控制代谢综合征后,报告不孕的女性发生心血管事件的几率高 71%(95% CI 1.01,3.00)。

结论

我们的研究结果表明,在美国女性中,任何时期的不孕经历都可能与女性后期的心血管健康有关。

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