Hong So-Hyeon, Hwang Soon Young, Yu Ji Hee, Kim Nam Hoon, Yoo Hye Jin, Seo Ji A, Kim Sin Gon, Kim Nan Hee, Baik Sei Hyun, Choi Kyung Mook
Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Biostatistics, College of Medicine, Korea University, Seoul, Republic of Korea.
Sci Rep. 2025 Jul 24;15(1):26972. doi: 10.1038/s41598-025-11976-x.
Despite the impact of pregnancy and parity on the prevalence of metabolic diseases, there are limited epidemiologic data regarding the association between parity and nonalcoholic fatty liver disease (NAFLD). We examined the association between parity, parity number, and NAFLD risk in pre- and postmenopausal women using data representing the entire Korean population. This cohort included 28,003 women (13,145 premenopausal and 14,858 postmenopausal) from the Korean National Health and Nutrition Examination Survey. NAFLD was defined by the hepatic steatosis index. Multivariable logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of NAFLD was 21.0% (15.3% in premenopausal women and 26.1% in postmenopausal women). In premenopausal women, parity increased the odds of NAFLD in the unadjusted model (OR 1.72, 95% CI 1.49-2.00), but after adjustment for potential confounders, including obesity, it exhibited a protective effect (OR 0.61, 95% CI 0.46-0.80). This finding was consistent when participants were divided into low parity (1-2 births) and high parity (3 or more births) groups (OR 0.59, 95% CI 0.45-0.79, and OR 0.64, 95% CI 0.47-0.87, respectively). In postmenopausal women, there was no significant statistical association between parity and NAFLD. These findings remained consistent across several sensitivity analyses excluding potential risk factors and in subgroup analyses. After adjusting for various confounding parameters, including obesity, parity was associated with a lower risk of NAFLD in premenopausal women. This suggests a protective effect of parity on NAFLD in premenopausal women, provided that appropriate body weight and other metabolic risk factors are maintained after delivery.
尽管妊娠和生育次数对代谢性疾病的患病率有影响，但关于生育次数与非酒精性脂肪性肝病（NAFLD）之间关联的流行病学数据有限。我们利用代表整个韩国人群的数据，研究了绝经前和绝经后女性的生育次数、生育胎次与NAFLD风险之间的关联。该队列包括来自韩国国家健康与营养检查调查的28,003名女性（13,145名绝经前女性和14,858名绝经后女性）。NAFLD由肝脏脂肪变性指数定义。采用多变量逻辑回归分析计算比值比（OR）和95%置信区间（CI）。NAFLD的患病率为21.0%（绝经前女性为15.3%，绝经后女性为26.1%）。在绝经前女性中，生育次数在未调整模型中增加了NAFLD的患病几率（OR 1.72，95% CI 1.49 - 2.00），但在调整包括肥胖在内的潜在混杂因素后，生育次数呈现出保护作用（OR 0.61，95% CI 0.46 - 0.80）。当参与者被分为低生育次数（1 - 2次分娩）和高生育次数（3次或更多次分娩）组时，这一发现是一致的（分别为OR 0.59，95% CI 0.45 - 0.79和OR 0.64，95% CI 0.47 - 0.87）。在绝经后女性中，生育次数与NAFLD之间没有显著的统计学关联。这些发现在排除潜在风险因素的多项敏感性分析和亚组分析中保持一致。在调整包括肥胖在内的各种混杂参数后，生育次数与绝经前女性较低的NAFLD风险相关。这表明生育次数对绝经前女性的NAFLD具有保护作用，前提是产后保持适当体重和其他代谢风险因素。
