Qu Shenao, Zhang Zhixuan, Ju Ran, Li Zhuoqun, Leng Jing, Xue Zihan, Han Xuan, Tao Shiran, Lv Yi, Zhang Nana
Center for Regenerative and Reconstructive Medicine, Med-X Institute of Western China Science and Technology Innovation Harbour, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China.
National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
BMC Public Health. 2024 Dec 24;24(1):3578. doi: 10.1186/s12889-024-21001-x.
Although many studies have reported the relationship between female hormone intake and cardiovascular disease (CVD) development, their association has not been fully elucidated and defined, based on data from the Third National Health and Nutrition Examination Survey intending to assess the health and nutritional status of non-institutionalized children and adults in the United States. This study examined the relationship between female hormone intake and coronary artery disease (CVD) development in 38,745 women, averaging 38.10 ± 12.59 years in age. We explored the association between hormone intake and CVD incidence, considering various social determinants of health (SDOH) with statistical methods like Chi-square tests, logistic regression, and stratified Chi-square analysis. Our findings reveal a complex relationship between female hormone intake and CVD development. Hormones appear to reduce CVD risk in women over 60 years old. However, hormone intake correlates with increased CVD risk in highly educated women. Socioeconomic status also influences this relationship; while hormones pose a risk factor for heart failure and stroke in impoverished or wealthy women, they serve as a protective factor against CVD for middle-income women. Additionally, hormonal intake seems beneficial for women who experienced menarche between 13 and 15 years old, menopause between 30 and 49, and had 7-9 pregnancies, especially when coupled with a diet low in sugar, fat, cholesterol, and adequate folic acid intake. These results indicate that while hormones can prevent CVD under specific conditions, their impact can be detrimental in different SDOH contexts. In conclusion, while appropriate hormone intake can prevent CVD, its effects vary across different demographic and health backgrounds. This underscores the necessity for meticulous screening of SDOH factors in clinical settings to maximize the protective benefits of hormones against CVD.
尽管许多研究报告了女性激素摄入与心血管疾病（CVD）发展之间的关系，但基于旨在评估美国非机构化儿童和成人健康与营养状况的第三次全国健康和营养检查调查数据，它们之间的关联尚未得到充分阐明和界定。本研究调查了38745名平均年龄为38.10±12.59岁的女性中女性激素摄入与冠状动脉疾病（CVD）发展之间的关系。我们使用卡方检验、逻辑回归和分层卡方分析等统计方法，探讨了激素摄入与CVD发病率之间的关联，并考虑了各种健康的社会决定因素（SDOH）。我们的研究结果揭示了女性激素摄入与CVD发展之间的复杂关系。激素似乎能降低60岁以上女性患CVD的风险。然而，在高学历女性中，激素摄入与CVD风险增加相关。社会经济地位也会影响这种关系；虽然激素在贫困或富裕女性中是心力衰竭和中风的风险因素，但在中等收入女性中却是预防CVD的保护因素。此外，激素摄入似乎对月经初潮在13至15岁之间、绝经在30至49岁之间且怀孕7至9次的女性有益，特别是当饮食中糖、脂肪、胆固醇含量低且叶酸摄入充足时。这些结果表明，虽然激素在特定条件下可以预防CVD，但其影响在不同的SDOH背景下可能是有害的。总之，虽然适当的激素摄入可以预防CVD，但其效果在不同的人口统计学和健康背景下有所不同。这凸显了在临床环境中仔细筛查SDOH因素的必要性，以最大限度地发挥激素对CVD的保护作用。
