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体脂分布与女性不孕:美国女性的横断面分析。

Body Fat Distribution and Female Infertility: a Cross-Sectional Analysis Among US Women.

机构信息

Department of Gynecology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, No.155, Hanzhong Road, Qinhuai District, Nanjing, 210000, Jiangsu Province, People's Republic of China.

Department of Orthopedics, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Reprod Sci. 2023 Nov;30(11):3243-3252. doi: 10.1007/s43032-023-01280-2. Epub 2023 Jun 5.

Abstract

At present, the effect of body fat distribution on female reproductive health is still inconclusive. The purpose of our study was to analyze the correlation between female infertility rates and the fat mass portion of the android region to the gynoid region (the A/G ratio) among US women of reproductive age. Female infertility is defined as a failure to get pregnant after 12 months of unprotected sexual activity. A total of 3434 women of reproductive age were included in this study as part of the 2013-2018 National Health and Nutrition Examination Survey (NHANES). The A/G ratio was used to assess the body fat distribution of participants. Based on the comprehensive study design and sample weights, it was determined that the A/G ratio was associated with female infertility primarily through logistic regression analyses. After adjusting for potential confounders, the multivariate regression analysis indicated an increase in the A/G ratio was correlated with an increase in the prevalence of female infertility (OR = 4.374, 95% CI:1.809-10.575). Subgroup analyses showed an increased prevalence of infertility in non-Hispanic Whites (P = 0.012), non-diabetic individuals (P = 0.008), individuals under 35 years old (P = 0.002), and individuals with secondary infertility (P = 0.01). The trend tests and smooth curve fitting illustrate a linear trend between the A/G ratio and female infertility. Future researches are warranted to confirm the causal relationship between body fat distribution and female infertility, which may provide an insight into future prevention and treatment of female infertility.

摘要

目前,体脂分布对女性生殖健康的影响仍不确定。本研究的目的是分析美国育龄妇女的女性不孕率与躯干脂肪量与臀型脂肪量之比(A/G 比)之间的相关性。女性不孕是指在无保护性行为 12 个月后仍未能怀孕。本研究共纳入 3434 名育龄妇女,作为 2013-2018 年全国健康与营养调查(NHANES)的一部分。A/G 比用于评估参与者的体脂分布。基于综合研究设计和样本权重,确定 A/G 比主要通过逻辑回归分析与女性不孕相关。在调整潜在混杂因素后,多元回归分析表明 A/G 比的增加与女性不孕患病率的增加相关(OR=4.374,95%CI:1.809-10.575)。亚组分析显示,非西班牙裔白种人(P=0.012)、非糖尿病患者(P=0.008)、年龄小于 35 岁的个体(P=0.002)和继发性不孕患者(P=0.01)的不孕患病率增加。趋势检验和平滑曲线拟合表明 A/G 比与女性不孕之间存在线性趋势。需要进一步的研究来确认体脂分布与女性不孕之间的因果关系,这可能为未来女性不孕的预防和治疗提供新的思路。

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