Boelling Miya, Pu Jiajie, Hanley Anthony J, Connelly Philip W, Sermer Mathew, Zinman Bernard, Retnakaran Ravi
Department of Medicine, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada.
Division of Endocrinology, University of Toronto, Toronto, ON M5S 3H2, Canada.
J Clin Endocrinol Metab. 2025 Jun 17;110(7):e2208-e2216. doi: 10.1210/clinem/dgae772.
Lactation is associated with lower future risk of cardiovascular disease (CVD) in women but the mechanism(s) underlying this relationship remain unclear.
We sought to characterize the relationship between duration of exclusive breastfeeding and CV risk factors over the first 5 years post partum.
In this prospective cohort study, 328 women underwent serial cardiometabolic characterization (anthropometry, blood pressure [BP], lipids, fasting glucose, adiponectin, C-reactive protein [CRP]) at 1 year, 3 years, and 5 years post partum. Outcomes were CV risk factors in 3 groups defined by duration of exclusive breastfeeding: less than 3 months (n = 107), 3 to 6 months (n = 101), and 6 months or more (n = 120).
The prevalence of metabolic syndrome did not differ between the groups at 3 years but, by 5 years post partum, was higher in women who had exclusively breastfed for less than 3 months than in those who did so for 3 to 6 and 6 months or more, respectively (14.0% vs 6.9% vs 4.2%; P = .02). However, after adjustment for covariates (including body mass index [BMI]), there were no statistically significant differences between groups in BP, glucose, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, or adiponectin. Indeed, the only CV risk factor difference that persisted after covariate adjustment was that women who had exclusively breastfed for less than 3 months had higher CRP both at 3 years (P = .04) and 5 years (P = .01). Moreover, generalized estimating equation analyses with adjustment for covariates (including time-dependent BMI) showed that CRP remained higher over time in these women, as compared to their peers, from 1 year to 3 years to 5 years post partum (P = .03).
Sustained reduction of subclinical inflammation may contribute to the cardioprotective effect of lactation in women.
哺乳期与女性未来患心血管疾病（CVD）的风险较低相关，但这种关系背后的机制仍不清楚。
我们试图描述产后头5年内纯母乳喂养持续时间与心血管疾病风险因素之间的关系。
在这项前瞻性队列研究中，328名女性在产后1年、3年和5年接受了一系列心脏代谢特征检查（人体测量、血压[BP]、血脂、空腹血糖、脂联素、C反应蛋白[CRP]）。结果是根据纯母乳喂养持续时间定义的3组中的心血管疾病风险因素：少于3个月（n = 107）、3至6个月（n = 101）和6个月或更长时间（n = 120）。
3年时，各组间代谢综合征的患病率没有差异，但到产后5年时，纯母乳喂养少于3个月的女性的患病率高于纯母乳喂养3至6个月和6个月或更长时间的女性（分别为14.0%对6.9%对4.2%；P = 0.02）。然而，在调整协变量（包括体重指数[BMI]）后，各组间在血压、血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯或脂联素方面没有统计学上的显著差异。事实上，协变量调整后唯一持续存在的心血管疾病风险因素差异是，纯母乳喂养少于3个月的女性在3年时（P = 0.04）和5年时（P = 0.01）的CRP更高。此外，在调整协变量（包括随时间变化的BMI）后的广义估计方程分析表明，与同龄人相比，这些女性从产后1年到3年再到5年，CRP随时间一直较高（P = 0.03）。
亚临床炎症的持续减轻可能有助于哺乳期对女性的心脏保护作用。
