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Li X, Wang S, Dunk M, Yang W, Qi X, Sun Z, Xu W. Association of life-course reproductive duration with mortality: a population-based twin cohort study. Am J Obstet Gynecol 2022; 227:748.e1-748.e13. [PMID: 35779587 DOI: 10.1016/j.ajog.2022.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/09/2022] [Accepted: 06/21/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Although age at menopause has been linked to mortality, the association between the entire reproductive lifespan and mortality remains unclear. OBJECTIVE This study aimed to examine to what extent life-course reproductive duration is associated with all-cause mortality and explore the role of a healthy lifestyle and familial background in such an association. STUDY DESIGN A total of 11,669 women (mean age, 63.54 years) from the Swedish Twin Registry were followed for up to 19 years. Information on reproductive duration (the interval between ages at menarche and menopause) and lifestyle factors (including smoking, alcohol consumption, and physical activity; divided into unfavorable/intermediate/favorable) was collected on the basis of a structured questionnaire. Survival status was obtained from the Sweden Cause of Death Register. The data were analyzed using generalized estimating equation models, Laplace regression, and conditional logistic regression. RESULTS In the generalized estimating equation model, compared with those with ≤34 reproductive years, the odds ratio (95% confidence interval) of all-cause mortality was 0.79 (0.68-0.90) for those with ≥40 reproductive years, which prolonged survival time by 0.84 (0.24-1.43) years. Women with ≥40 reproductive years plus a favorable lifestyle (odds ratio, 0.28; 95% confidence interval, 0.23-0.35) were at a lower risk of all-cause mortality than those with <40 reproductive years plus an unfavorable lifestyle. An additive interaction between ≥40 reproductive years and a favorable lifestyle on all-cause mortality was observed (attributable proportion, 0.584; 95% confidence interval, 0.016-1.151). The odds ratios in conditional logistic regression and generalized estimating equation models did not differ significantly (P=.67). CONCLUSION A longer reproductive lifespan is associated with reduced all-cause mortality and prolongs survival by 0.84 years. A favorable lifestyle may amplify the beneficial effect of longer reproductive lifespan on mortality. Familial background does not account for the observed association.
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Affiliation(s)
- Xuerui Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China
| | - Shuqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China
| | - Michelle Dunk
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden; Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Wenzhe Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China
| | - Zhuoyu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China.
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.
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Gu YW, Zhang S, Wang JH, Yang HL, Zhang SQ, Yao YD, Wu YY, Xie L, Li ZY, Cao JY. Number of Births and Risk of Diabetes in China's Older Women. Front Med (Lausanne) 2022; 9:798787. [PMID: 35559347 PMCID: PMC9087266 DOI: 10.3389/fmed.2022.798787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
As an important life event in individuals' life, childbirth will affect the health of women to different degrees. More and more attention has been paid to whether the number of births will affect the incident diabetes in elderly women, but there are few related studies. Based on the data of the Chinese Longitudinal Healthy Longevity Survey in 2018, 6,159 older women are selected as the study population. Logistic regression analyses are used to estimate the relationship between the number of births and diabetes risk. For each additional birth, the odds ratio of maternal diabetes will decrease by 6.9% and the result is significant at the 1% level, especially among mothers having four children or less. The conclusion is equally applicable in the sample of fathers and urban mothers, but the increase in the number of births will increase the risk of diabetes in rural mothers, although this result is not statistically significant. Later age at first birth, later age at last birth, the longer childbearing period, and birth interval will significantly reduce the risk of diabetes.
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Affiliation(s)
- Ying-Wen Gu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Shuo Zhang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Jia-Hao Wang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Hua-Lei Yang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Si-Qing Zhang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Yi-Dan Yao
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Yuan-Yang Wu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Lin Xie
- Institution of Population and Labor Economics, University of Chinese Academy of Social Science, Beijing, China
| | - Zhi-Yun Li
- College of Politics and Public Administration, Qingdao University, Qingdao, China
| | - Jin-Yan Cao
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
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Association between Reproductive Span and Sarcopenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010154. [PMID: 33379287 PMCID: PMC7795620 DOI: 10.3390/ijerph18010154] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 01/18/2023]
Abstract
Sarcopenia is defined as an age-related loss of skeletal muscle and is associated with several health disorders. Causes of sarcopenia, which included physical inactivity, alcohol, dietary habits, and smoking, have been researched. The present study was undertaken to examine the association between reproductive span and sarcopenia in Korean women. Data obtained from 2008 to 2011 Korea National Health and Nutrition Examination Surveys (KNHANES) were analyzed. We defined sarcopenia based on the cut-off values of the Foundation for the National Institutes of Health (FNIH) sarcopenia project criteria: ASM/BMI < 0.512 for women. Reproductive span was defined as years from menarche to menopause, and we divided the 3970 study subjects into three groups by reproductive span tertile. Multivariate logistic regression analysis was used to determine adjusted ORs for the relation between reproductive span and sarcopenia. The prevalence of sarcopenia in the study was 17.7% (704 of 3970). Multiple logistic regression analysis was performed using weighted populations. After adjusting for covariates, reproductive span was found to be inversely associated with the risk of sarcopenia [Tertile 1 = 1 (reference); Tertile 2, odds ratio (OR) = 0.927, 95% confidence interval (CI) = 0.863–0.995; Tertile 3, OR = 0.854, 95% CI = 0.793–0.915].
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