Department of Obstetrics, Shenzhen Maternity and Child Healthcare Hospital, The First School of Clinical Medicine, Southern Medical University, Shenzhen, 518028, China.
Department of Obstetrics and Gynecology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China.
Arch Gynecol Obstet. 2024 Jun;309(6):2591-2603. doi: 10.1007/s00404-023-07154-x. Epub 2023 Aug 1.
This study aimed at investigating the associations between the total body mass index (BMI) change at 3 or 4 years postpartum compared to the prepregnancy and cardiometabolic risk factors.
This longitudinal study included 1305 participants. Based on the total postpartum BMI changes, they were divided into < 0 units, 0-1.7 units, and > 1.7 units groups using the interquartile range. Multiple linear regression models were used to analyze the associations.
Compared to the reference group, there was a progressive increase in the βcoefficient (βcoef) of homeostasis model assessment of insulin resistance (HOMA-IR) of cardiometabolic risk in the following groups: the '0-1.7 units' group with the 'overweight traj' [βcoef 0.33; 95% confidence intervals (CI) 0.22, 0.44)] or the 'obesity traj' [0.66; (0.45, 0.88)] and the '> 1.7 units' group with the 'normal traj' [0.33; (0.22, 0.44)], the 'overweight traj' [0.54; (0.41, 0.67)] or the 'obesity traj' [0.97; (0.79, 1.15)]. The same increasing trend of βcoef was also found in DBP, FPG, LDL, WHR, BF%. However, the '< 0 units' group with the 'low traj' [0.13; (0.06, 0.21)] and the '0-1.7 units' group with the 'low traj' [0.08; (0.03, 0.13)] had higher high-density lipoprotein cholesterol (HDL-C) level than the reference group.
Women with a postpartum BMI gain > 1.7 units are positively associated with cardiometabolic risk factors, especially for those in the 'obesity traj' or 'traj D'. Conversely, women with a postpartum BMI loss > 0 units have negative association with cardiometabolic risk factors, especially for those in the 'low traj' or 'traj B'.
本研究旨在探讨与妊娠前相比，产后 3 或 4 年的体重指数（BMI）变化与心血管代谢风险因素之间的关系。
这项纵向研究纳入了 1305 名参与者。根据产后 BMI 的总体变化，使用四分位间距将她们分为<0 单位、0-1.7 单位和>1.7 单位组。使用多元线性回归模型分析相关性。
与参照组相比，以下各组的心血管代谢风险的稳态模型评估胰岛素抵抗（HOMA-IR）β 系数（βcoef）逐渐增加：“0-1.7 单位”组中具有“超重轨迹”[βcoef 0.33；95%置信区间（CI）0.22，0.44)]或“肥胖轨迹”[0.66；（0.45，0.88)]和“>1.7 单位”组中具有“正常轨迹”[0.33；（0.22，0.44)]，“超重轨迹”[0.54；（0.41，0.67)]或“肥胖轨迹”[0.97；（0.79，1.15)]。DBP、FPG、LDL、WHR、BF% 也存在同样的βcoef 增加趋势。然而，“<0 单位”组中的“低轨迹”[0.13；（0.06，0.21)]和“0-1.7 单位”组中的“低轨迹”[0.08；（0.03，0.13)]的高密度脂蛋白胆固醇（HDL-C）水平高于参照组。
产后 BMI 增加>1.7 单位的女性与心血管代谢风险因素呈正相关，尤其是那些处于“肥胖轨迹”或“轨迹 D”的女性。相反，产后 BMI 减少>0 单位的女性与心血管代谢风险因素呈负相关，尤其是那些处于“低轨迹”或“轨迹 B”的女性。
