初育年龄与中年和老年女性虚弱的可能性相关：来自 NHANES 1999-2018 的基于人群的分析。
Age at first birth is associated with the likelihood of frailty in middle-aged and older women: A population-based analysis from NHANES 1999-2018.
机构信息
Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong 511400, China.
Department of Rehabilitation Medicine, Key Laboratory of Biological Targeting Diagnosis, Therapy and Rehabilitation of Guangdong Higher Education Institutes, The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510700, China.
出版信息
Maturitas. 2024 Mar;181:107904. doi: 10.1016/j.maturitas.2023.107904. Epub 2023 Dec 25.
OBJECTIVES
This study examined whether age at first birth (AFB) is associated with the prevalence of frailty in middle-aged and older women.
METHODS
The study included 10,828 women (age ≥ 45 years) from the National Health and Nutrition Examination Survey (NHANES) (1999-2018) in the United States. AFB data were collected using a standardized reproductive health questionnaire. Frailty was measured using a 53-item frailty index and was diagnosed if the score on that index was over 0.21. Survey-weighted logistic regression models were used to assess the association between AFB and the prevalence of frailty. A survey-weighted restricted cubic spline (RCS) model was used to determine the dose-response relationship between AFB and frailty. Mediation analyses were performed to estimate the mediated effects of education levels, family poverty income ratio, and parity on the association between AFB and the likelihood of frailty. Finally, sensitivity and subgroup analyses were conducted to validate the robustness of our findings.
RESULTS
Among the 10,828 women, 3828 (35.4 %) had frailty. The RCS depicted a U-shaped association between AFB and frailty. Compared with the women in the reference group (AFB: 33-35 years), women in the other groups (AFB: < 18, 18-20, 21-23, and 24-26 years) had a higher likelihood of frailty, with respective odds ratios (95 % confidence intervals) of 3.02 (1.89-4.83), 2.32 (1.54-3.50), 1.83 (1.19-2.81), and 1.64 (1.07-2.53). However, no statistically significant differences were detected for women with AFB of 27-29, 30-32, or > 35 years compared with the reference group. Education levels, family poverty income ratio, and parity significantly mediated the approximately linear negative association between AFB and frailty in the subset of women with AFB of ≤32 years and the mediation proportions were 23.4 %, 32.4 %, and 18.3 %, respectively (all p < 0.001).
CONCLUSIONS
Based on our results, we conclude that early AFB is associated with a higher likelihood of frailty in middle-aged and older women.
目的
本研究旨在探讨初育年龄（age at first birth，AFB）与中年及以上女性衰弱症的患病率之间是否存在关联。
方法
本研究纳入了美国国家健康和营养检查调查（National Health and Nutrition Examination Survey，NHANES）（1999-2018 年）中的 10828 名年龄≥45 岁的女性。使用标准化生殖健康问卷收集 AFB 数据。使用 53 项衰弱指数来衡量衰弱程度，如果该指数得分超过 0.21，则诊断为衰弱。采用调查加权逻辑回归模型评估 AFB 与衰弱症患病率之间的关联。采用调查加权限制三次样条（restricted cubic spline，RCS）模型确定 AFB 与衰弱症之间的剂量-反应关系。进行中介分析以估计教育水平、家庭贫困收入比和产次对 AFB 与衰弱症可能性之间关联的中介效应。最后，进行敏感性和亚组分析以验证研究结果的稳健性。
结果
在 10828 名女性中，3828 名（35.4%）患有衰弱症。RCS 描绘了 AFB 与衰弱症之间呈 U 型关联。与参考组（AFB：33-35 岁）相比，其他组（AFB：<18 岁、18-20 岁、21-23 岁和 24-26 岁）的女性衰弱症的可能性更高，相应的比值比（95%置信区间）分别为 3.02（1.89-4.83）、2.32（1.54-3.50）、1.83（1.19-2.81）和 1.64（1.07-2.53）。然而，AFB 为 27-29 岁、30-32 岁或>35 岁的女性与参考组相比，差异无统计学意义。教育水平、家庭贫困收入比和产次显著中介了 AFB 与衰弱症之间的近似线性负相关关系，在 AFB 为≤32 岁的女性亚组中，中介比例分别为 23.4%、32.4%和 18.3%（均<0.001）。
结论
根据我们的研究结果，我们得出结论，初育年龄较早与中年及以上女性衰弱症的可能性增加有关。
Zotero 插件