探讨子宫肌瘤在糖尿病暴露促进心血管疾病中的作用：1999 - 2006年美国国家健康与营养检查调查结果
Exploring the role of uterine fibroids in promotion of cardiovascular diseases by diabetes exposure: Findings from national health and nutrition examination survey 1999-2006.
作者信息
Li Bin, Yuan Zhen, Zhang Yizhi, Li Feng, Huang Lin, Yang Zhihui, Liu Haiyue, Liu Zuheng
机构信息
Department of Cardiology, Xiamen Chang Gung Hospital, School of Medicine, Huaqiao University, Xiamen, China.
School of Public Health, Southwest Medical University, Luzhou, China.
出版信息
Front Cardiovasc Med. 2022 Aug 9;9:975920. doi: 10.3389/fcvm.2022.975920. eCollection 2022.
OBJECTIVE
The relationship between uterine fibroids (UF) and cardiovascular diseases (CVDs) in the diabetes population seemed to remain undetermined in previous studies. This study aims to explore the association between UF and CVDs by using the database from the National Health and Nutrition Examination Survey (NHANES). To further evaluate the connection between UF and CVDs we also tested the potential differences due to diabetes exposure.
MATERIALS AND METHODS
National Health and Nutrition Examination Survey data (1999-2006) were collected and used in this study. A total of 5,509 individuals were included and analyzed. The student's -test and the chi-squared test were used to explore the demographic characteristic between UF and non-UF groups. Logistic regression analysis was performed to determine the odds ratios of UF and covariates.
RESULTS
Female participants were divided into UF ( = 694, 12.60%) and non-UF ( = 4,815, 87.40%) groups. The incidence of CVDs in UF patients ( = 245, 35.30%) were higher than non-UF individuals ( = 776, 16.12%) ( < 0.001). In addition, each subtype of CVDs were also different, which contains hypertension (33.29 vs. 15.31%, < 0.001), heart failure (1.59 vs. 0.52%, < 0.01), angina (2.59 vs. 0.62%, < 0.001), heart attack (1.73 vs. 0.58%, < 0.01) and coronary heart disease (1.44 vs. 0.54%, < 0.01). The odds ratios of CVDs according to logistic regression were 2.840 (95% CI: 2.387-3.379) for UF patients ( < 0.001), while the odds ratios (ORs) were 1.438 (95% CI: 1.175-1.760) after taking account for the age, body mass index (BMI), diabetes, race, education, and annual family income ( < 0.001). In addition, secondary analysis indicated more adverse effects in by UF exposure on CVDs risk among non-diabetes individuals (OR = 1.389, 95% CI = 1.124-1.718, < 0.01) than diabetes patients ( = 0.063).
CONCLUSION
Overall, UFs were positively associated with CVDs, and this effect seems blunted by diabetes exposure.
目的
在糖尿病患者群体中，子宫肌瘤（UF）与心血管疾病（CVD）之间的关系在既往研究中似乎尚未明确。本研究旨在利用美国国家健康与营养检查调查（NHANES）数据库探讨UF与CVD之间的关联。为进一步评估UF与CVD之间的联系，我们还测试了糖尿病暴露所导致的潜在差异。
材料与方法
本研究收集并使用了1999 - 2006年的美国国家健康与营养检查调查数据。共纳入5509名个体并进行分析。采用学生t检验和卡方检验来探讨UF组与非UF组之间的人口统计学特征。进行逻辑回归分析以确定UF及协变量的比值比。
结果
女性参与者被分为UF组（n = 694，12.60%）和非UF组（n = 4815，87.40%）。UF患者中CVD的发生率（n = 245，35.30%）高于非UF个体（n = 776，16.12%）（P < 0.001）。此外，CVD的各亚型也存在差异，包括高血压（33.29%对15.31%，P < 0.001）、心力衰竭（1.59%对0.52%，P < 0.01）、心绞痛（2.59%对0.62%，P < 0.001）、心脏病发作（1.73%对0.58%，P < 0.01）和冠心病（1.44%对0.54%，P < 0.01）。根据逻辑回归，UF患者发生CVD的比值比为2.840（95%置信区间：2.387 - 3.379）（P < 0.001），而在考虑年龄、体重指数（BMI）、糖尿病、种族、教育程度和家庭年收入后，比值比（OR）为1.438（95%置信区间：1.175 - 1.760）（P < 0.001）。此外，二次分析表明，与糖尿病患者相比（P = 0.063），UF暴露对非糖尿病个体CVD风险的不良影响更大（OR = 1.389，95%置信区间 = 1.124 - 1.718，P < 0.01）。
结论
总体而言，UF与CVD呈正相关，且这种效应似乎因糖尿病暴露而减弱。
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