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Rasul MG, Fahim SM, Alam MA, Das S, Mostafa I, Mahfuz M, Ahmed T. Prevalence and factors associated with undernutrition and overnutrition among ever-married adolescent girls in Bangladesh: an analysis of national surveys from 2004 to 2017. J Biosoc Sci 2024; 56:292-313. [PMID: 37712505 DOI: 10.1017/s0021932023000160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Nutritional impairment during adolescence may result in adverse physical and reproductive health outcomes. We investigated the prevalence and determined the factors associated with underweight and overweight/obesity among ever-married adolescent girls in Bangladesh. We used Bangladesh Demographic and Health Surveys data conducted in 2004, 2007, 2011, 2014, and 2017. A total of 7040 ever-married adolescent girls aged 15-19 years were included in this analysis. Prevalence of underweight (body mass index [BMI]<18.5 kg/m2) significantly decreased from 39.53% (95% CI = 36.71, 42.43) to 23.62% (95% CI = 21.35, 26.05) during 2004-2017 (p < 0.001). However, prevalence of overweight/obesity (BMI ≥ 23 kg/m2) significantly increased from 5.9% (95% CI = 4.67, 7.43) to 22.71% (95% CI = 20.39, 25.20) during the same period (p < 0.001). The girls with higher age (OR = 0.94, 95% CI = 0.90, 0.99, p = 0.023), higher level of education (OR = 0.60, 95% CI = 0.43, 0.83, p = 0.002), and richest wealth quintile (OR = 0.78, 95% CI = 0.62, 0.98, p = 0.035) had significantly lower risk of being underweight. Adolescent girls having more than one child (OR = 1.41, 95% CI = 1.15, 1.73, p = 0.001) were more likely to be underweight. Elderly adolescents with better economic status were more at risk of being overweight/obese (OR = 2.57, 95% CI = 1.86, 3.55, p < 0.001). Girls married to skilled/unskilled workers (OR = 0.58, 95% CI = 0.44, 0.77, p < 0.001) and persons involved in small businesses (OR = 0.66, 95% CI = 0.49, 0.89, p = 0.007) had lower risk of having a high BMI. Using contraceptive (OR = 0.8, 95% CI = 0.69, 0.94, p = 0.006) was negatively associated with overweight/obese. Although prevalence of undernutrition among ever-married adolescent girls is declining, the proportion of being overweight/obese is increasing in Bangladesh warranting effective strategies to improve adolescent nutrition.
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Affiliation(s)
- Md Golam Rasul
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shah Mohammad Fahim
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Ashraful Alam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Subhasish Das
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ishita Mostafa
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- Global Health Department, University of Washington, Seattle, Washington, USA
- Department of Public Health Nutrition, James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Kim DS, Kim HJ, Kim MK, Jin JC, Han DH, Kim SM. Obstetric and psychiatric history as predictors for psychosomatic symptoms among Korean perimenopausal women. Maturitas 2023; 178:107827. [PMID: 37659129 DOI: 10.1016/j.maturitas.2023.107827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/08/2023] [Accepted: 08/14/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVES Menopause presents various physical and psychological disturbances for women and comes at a high financial cost. Therefore, this study aimed to identify factors influencing menopause symptoms. STUDY DESIGN Data of Korean perimenopausal women aged 40-60 (n = 1060; mean age, 46.03 ± 4.08) were collected by a research company. Participants were classified into a "functional" group (n = 716) or a "dysfunctional" group (n = 344) according to the severity of their perimenopausal psychosomatic symptoms. To investigate the association of obstetric and psychiatric history with membership of the "dysfunctional" group, a hierarchical logistic regression analysis was conducted. RESULTS The outcomes of all three hierarchical logistic regression models presented significant overall model fit. Among the independent variables, family history of menopausal symptoms, menarcheal age, number of pregnancies, history of postpartum depression, postpartum psychosis, and other psychiatric disorders were positively associated with being in the "dysfunctional" group, whereas age and number of deliveries were negatively associated with being in the "dysfunctional" group. CONCLUSION A short reproductive period and short exposure to estrogen due to late menarche and early menopausal transition may be related to severe perimenopausal symptoms. The relationship between the history of postpartum mental illness and severe perimenopausal symptoms may be associated with heightened sensitivity to hormonal triggers when a woman is exposed to fluctuating ovarian sex steroid levels. The relationship between parity or gravidity and the severity of menopausal symptoms in Korean women differed from that in studies conducted in other countries, possibly due to the low birth rate in Korea.
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Affiliation(s)
- Da Seul Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Hee Jun Kim
- Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Min Kyoon Kim
- Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Jae-Chan Jin
- School of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Sun Mi Kim
- Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
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Su H, Jiang C, Zhang W, Zhu F, Jin Y, Cheng K, Lam T, Xu L. Parity and incident type 2 diabetes in older Chinese women: Guangzhou Biobank Cohort Study. Sci Rep 2023; 13:9504. [PMID: 37308533 DOI: 10.1038/s41598-023-36786-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023] Open
Abstract
This study examined the association between parity and incident type 2 diabetes in older Chinese women and estimated the mediation effect of adiposity indicators. A total of 11,473 women without diabetes at baseline from 2003 to 2008 were followed up until 2012. We used Cox proportional hazards regression to assess the association between parity and incident type 2 diabetes, and mediation analysis to estimate the mediation effect of adiposity indicators. Compared to women with one parity, the hazard ratio (HR) (95% confidence interval (CI)) for incident type 2 diabetes was 0.85 (0.44-1.63), 1.20 (1.11-1.30), 1.28 (1.16-1.41) and 1.27 (1.14-1.42) for women with parity of 0, 2, 3, and ≥ 4, respectively. The proportion of indirect effect (95% CI) mediated by body mass index, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio and body fat percentage was 26.5% (19.2-52.2%), 54.5% (39.4-108.7%), 25.1% (18.2-49.1%), 35.9% (25.6-74.1%), 50.3% (36.5-98.6%) and 15.1% (- 66.4 to 112.3%), respectively. Compared to women with one parity, women with multiparity (≥ 2) had a higher risk of incident type 2 diabetes and up to half of the association was mediated by abdominal obesity.
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Affiliation(s)
- Huimin Su
- School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Chaoqiang Jiang
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Weisen Zhang
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
| | - Feng Zhu
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Yali Jin
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Karkeung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Taihing Lam
- Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
- School of Public Health, The University of Hong Kong, Hong Kong, 999077, China
| | - Lin Xu
- School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.
- School of Public Health, The University of Hong Kong, Hong Kong, 999077, China.
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Bai L, Yang X, Sun Z, Luo Z, Li L, Liang X, Zhou J, Meng L, Peng Y, Qin Y. Reproductive factors and metabolic syndrome among Chinese women aged 40 years and older. J Diabetes 2023; 15:36-46. [PMID: 36526334 PMCID: PMC9870746 DOI: 10.1111/1753-0407.13342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/08/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of this study is to explore the relationship between reproductive variables and the prevalence of metabolic syndrome (MetS) and its components among Chinese women aged 40 years and older. METHODS A cross-sectional study was conducted among 4453 women aged 40 years and older in Guangxi, China. The associations between women's reproductive factors and MetS were analyzed using a logistic regression model. RESULTS The prevalence of MetS was 23.9% in this population. Women with MetS were mostly older, more likely to be postmenopausal, and had higher parity. Compared to women with one prior live birth, those with three or more live births had the highest odds of having MetS (odds ratio [OR] = 1.56; 95% CI, 1.23-1.99). Similarly, compared to premenopausal women, postmenopausal participants had higher odds of having MetS (OR = 1.86; 95% CI, 1.49-2.31). No associations were observed between MetS and abortion or with age at menarche. CONCLUSIONS Our study suggests that multiparity and menopausal status may be associated with the development of MetS. The inconsistency seen in epidemiological research to date calls for further investigation.
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Affiliation(s)
- Ling Bai
- Department of CardiologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
- Guangxi Key Laboratory Base of Precision Medicine in Cardio‐cerebrovascular Diseases Control and Prevention and Guangxi Clinical Research Center for Cardio‐cerebrovascular DiseasesGuangxi Medical UniversityNanningChina
| | - Xi Yang
- Guangxi Key Laboratory Base of Precision Medicine in Cardio‐cerebrovascular Diseases Control and Prevention and Guangxi Clinical Research Center for Cardio‐cerebrovascular DiseasesGuangxi Medical UniversityNanningChina
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Ziyi Sun
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Zuojie Luo
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Li Li
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Xinghuan Liang
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Jia Zhou
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Liheng Meng
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Yang Peng
- Department of Occupational and Environmental HealthSchool of Public Health, Guangxi Medical UniversityNanningChina
| | - Yingfen Qin
- Department of EndocrinologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
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Sun MH, Wen ZY, Wang R, Gao C, Yin JL, Chang YJ, Wu QJ, Zhao YH. Parity and Metabolic Syndrome Risk: A Systematic Review and Meta-Analysis of 15 Observational Studies With 62,095 Women. Front Med (Lausanne) 2022; 9:926944. [PMID: 35903312 PMCID: PMC9314745 DOI: 10.3389/fmed.2022.926944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background Epidemiological studies have provided inconsistent evidence of the association between parity and metabolic syndrome (MetS) risk. We conducted this first systematic review and meta-analysis to comprehensively and precisely quantify this topic. Methods Comprehensive searches of PubMed, Embase, and the Web of Science databases were conducted to identify observational studies of the association between parity and MetS risk up to 30 January 2022. Study inclusion, data extraction, and quality assessment were checked and reviewed by two investigators independently. Random-effects models were applied to estimate pooled odds ratios (ORs) and 95% CIs. This study has been registered with PROSPERO. Results Two high-quality cohorts and thirteen medium-quality cross-sectional studies involving 62,095 women were finally included. Compared with the nulliparous, the pooled OR of MetS for the ever parity was 1.31 (95% CI = 0.91–1.88, I2 = 72.6%, n = 3). Compared with the lowest parity number, the pooled OR of MetS for the highest parity number was 1.38 (95% CI = 1.22–1.57, I2 = 60.7%, n = 12). For the dose-response analysis, the pooled OR of MetS for each increment of one live birth was 1.12 (95% CI = 1.05–1.19, I2 = 78.6%, n = 6). These findings were robust across subgroups and sensitivity analyses. No evidence of heterogeneity between subgroups was indicated by meta-regression analyses. Conclusion The findings suggested that parity was associated with an increased risk of MetS. A sufficient number of large prospective cohort studies are required to fully verify our findings. Systematic Review Registration [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022307703].
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Affiliation(s)
- Ming-Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ran Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Li Yin
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Jiao Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Qi-Jun Wu,
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- Yu-Hong Zhao,
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6
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Ohashi M, Miura K, Takashima N, Kadota A, Saito Y, Tsuji S, Murakami T, Kadomatsu Y, Nagayoshi M, Hara M, Tanaka K, Tamura T, Hishida A, Takezaki T, Shimoshikiryo I, Ozaki E, Watanabe I, Suzuki S, Watanabe M, Kuriki K, Arisawa K, Katsuura-Kamano S, Yamasaki S, Ikezaki H, Oze I, Koyanagi YN, Mikami H, Nakamura Y, Takeuchi K, Kita Y, Wakai K. The association of reproductive history with hypertension and obesity according to menopausal status: the J-MICC Study. Hypertens Res 2022; 45:708-714. [PMID: 35031776 DOI: 10.1038/s41440-021-00820-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/26/2021] [Accepted: 11/08/2021] [Indexed: 11/08/2022]
Abstract
Previous studies have reported that the number of pregnancies and childbirths affected the risk of cardiovascular diseases (CVDs). However, the influence of reproductive history on hypertension and obesity, which are important risk factors for CVDs, is still unclear. Moreover, this association may vary depending on menopausal status. We evaluated the association of reproductive history with hypertension and obesity using a large cross-sectional dataset from the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). At the baseline survey, physical data, blood samples, and self-reported health questionnaires were collected. Participants with insufficient data were excluded, and 24,558 women from eight study regions were included in this study. Logistic regression analysis was conducted to evaluate the association of reproductive history with hypertension and obesity using multivariable-adjusted odds ratios. In premenopausal women, childbirth showed a generally protective effect on hypertension but not on obesity. In postmenopausal women, childbirth was positively associated with obesity and hypertension but not with hypertension after adjusting for BMI. In conclusion, reproductive history was associated with hypertension and obesity in a large Japanese population, and this association differed between premenopausal and postmenopausal women.
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Affiliation(s)
- Mizuki Ohashi
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan.
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Naoyuki Takashima
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Yoshino Saito
- Department of Health Science, Aino University, Osaka, Japan
| | - Shunichiro Tsuji
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan
| | - Takashi Murakami
- Department of Obstetrics and Gynecology, Shiga University of Medical Science, Otsu, Japan
| | - Yuka Kadomatsu
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ippei Shimoshikiryo
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
| | - Yuriko N Koyanagi
- Division of Cancer Information and Control, Aichi Cancer Center, Nagoya, Japan
| | - Haruo Mikami
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshikuni Kita
- Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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7
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Matsunaga T, Kadomatsu Y, Tsukamoto M, Kubo Y, Okada R, Nagayoshi M, Tamura T, Hishida A, Takezaki T, Shimoshikiryo I, Suzuki S, Nakagawa H, Takashima N, Saito Y, Kuriki K, Arisawa K, Katsuura-Kamano S, Kuriyama N, Matsui D, Mikami H, Nakamura Y, Oze I, Ito H, Murata M, Ikezaki H, Nishida Y, Shimanoe C, Takeuchi K, Wakai K. Associations of breastfeeding history with metabolic syndrome and cardiovascular risk factors in community-dwelling parous women: The Japan Multi-Institutional Collaborative Cohort Study. PLoS One 2022; 17:e0262252. [PMID: 35045125 PMCID: PMC8769371 DOI: 10.1371/journal.pone.0262252] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of the present study was to investigate the associations between breastfeeding and the prevalence of metabolic syndrome in community-dwelling parous women and to clarify whether the associations depend on age. METHODS The present cross-sectional study included 11,118 women, aged 35-69 years. Participants' longest breastfeeding duration for one child and their number of breastfed children were assessed using a self-administered questionnaire, and their total breastfeeding duration was approximated as a product of the number of breastfed children and the longest breastfeeding duration. The longest and the total breastfeeding durations were categorized into none and tertiles above 0 months. Metabolic syndrome and cardiovascular risk factors (obesity, hypertension, dyslipidemia, and hyperglycemia) were defined as primary and secondary outcomes, respectively. Associations between breastfeeding history and metabolic syndrome or each cardiovascular risk factor were assessed using multivariable unconditional logistic regression analysis. RESULTS Among a total of 11,118 women, 10,432 (93.8%) had ever breastfed, and 1,236 (11.1%) had metabolic syndrome. In participants aged <55 years, an inverse dose-response relationship was found between the number of breastfed children and the prevalence of metabolic syndrome; multivariable-adjusted odds ratios for 1, 2, 3, and ≥4 breastfed children were 0.60 (95% confidence interval [CI]: 0.31 to 1.17), 0.50 (95% CI: 0.29 to 0.87), 0.44 (95% CI: 0.24 to 0.84), and 0.35 (95% CI: 0.14 to 0.89), respectively. The longest and total breastfeeding durations of longer than 0 months were also associated with lower odds of metabolic syndrome relative to no breastfeeding history in participants aged <55 years. In contrast, all measures of breastfeeding history were not significantly associated with metabolic syndrome and cardiovascular risk factors in participants aged ≥55 years old. CONCLUSIONS Breastfeeding history may be related to lower prevalence of metabolic syndrome in middle-aged parous women.
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Affiliation(s)
- Takashi Matsunaga
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yuka Kadomatsu
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Ippei Shimoshikiryo
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Hiroko Nakagawa
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Yoshino Saito
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
- Department of Nursing, Faculty of Health Science, Aino University, Ibaraki, Osaka, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Division of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Shizuoka, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Tokushima, Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Tokushima, Japan
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan
| | - Daisuke Matsui
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan
| | - Haruo Mikami
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Chiba, Japan
| | - Yohko Nakamura
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Chiba, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
| | - Hidemi Ito
- Division of Cancer Information and Control, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Fukuoka, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Fukuoka, Japan
| | - Yuichiro Nishida
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Saga, Japan
| | - Chisato Shimanoe
- Department of Pharmacy, Saga University Hospital, Saga, Saga, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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8
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Moazzeni SS, Asgari S, Azizi F, Hadaegh F. Live birth/parity number and the risk of incident hypertension among parous women during over 13 years of follow-up. J Clin Hypertens (Greenwich) 2021; 23:2000-2008. [PMID: 34657376 PMCID: PMC8630610 DOI: 10.1111/jch.14369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/30/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022]
Abstract
The effect of live birth/parity number on incident hypertension was investigated among Iranian parous women aged 30–70 years. The study population included 2188 normotensive women who were enrolled in 1999–2001. They were followed for incident hypertension (based on JNC 7 report) by 3‐year intervals up to April 2018. Multivariable Cox proportional hazard models, adjusted for a wide set of potential hypertension risk factors, reproductive factors, and pregnancy complications, were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the number of parity/live birth(s) for incident hypertension. Additionally, as a sensitivity analysis, age‐scale Cox regression was also done. During a median follow‐up of 13.5 years, 935 incident hypertension have occurred. Compared to those with two live births, the participants who had 3 and ≥4 live births were at higher risk of hypertension development by the HRs of 1.25 [95% CI: 1.02–1.55] and 1.39 [1.12–1.72], respectively, in the full‐adjusted model. Moreover, each additional live birth increased the risk of hypertension by a HR of 1.06 [95%CI: 1.02–1.11]. Results of parity number were also similar. Considering age as time scale also did not change the results generally. The authors found a significant interaction between live birth/parity number and age groups; the adverse effect of higher live birth/parity numbers on hypertension development was mainly found among those aged < 50 years. To sum up, compared to the live birth/parity number of two, Iranian women with ≥3 live birth/parity had a higher risk of incident hypertension; the issue was more prominent among younger mothers.
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Affiliation(s)
- Seyyed Saeed Moazzeni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhu D, Fang F, Zhang X, Han R, Liu F, Wang H. Childbearing age is correlated with components of metabolic syndrome and parameters of insulin resistance in Chinese menopausal women. Gynecol Endocrinol 2021; 37:201-205. [PMID: 33135512 DOI: 10.1080/09513590.2020.1841159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To assess the relationship between childbearing age and elements of metabolic syndrome (MS) among menopausal women in China. MATERIALS AND METHODS One thousand one hundred and forty-one subjects were divided into four interim average childbearing age (ACA) groups: ≥16 < 24 years old, ≥24 < 29 years old, ≥29 < 34 years old, and ≥34 years old. The group with the lowest prevalence of MS was used as a control. Body mass index, waist circumference (WC) and waist-to-hip ratio were assessed. Plasma glucose, lipids, glycated hemoglobin (HbA1c) and fasting insulin (FINS) were measured. Insulin resistance (IR) was assessed using the homeostasis model assessment (HOMA) method. RESULTS The prevalence of MS in the 16-24 and 29-34 age groups was higher than that in the control group (p < .05). Compared with the control group, the odds ratios of MS were 1.431 for the 16-24 group (p < .05) and 1.553 for the 29-34 group (P < 0.01). ACA was correlated with FINS, HOMA-IR, WC, fasting plasma glucose, and triglycerides independent of age (p < .05). CONCLUSIONS Average childbearing age was correlated with parameters of IR and components of MS independent of age in Chinese menopausal women.
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Affiliation(s)
- Danping Zhu
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Fang Fang
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Xia Zhang
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Rui Han
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Fang Liu
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Hang Wang
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
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10
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Shi M, Zhou X, Zheng C, Pan Y. The association between parity and metabolic syndrome and its components in normal-weight postmenopausal women in China. BMC Endocr Disord 2021; 21:8. [PMID: 33413314 PMCID: PMC7792174 DOI: 10.1186/s12902-020-00674-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/22/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Studies analyzing the association between parity and normal-weight metabolic syndrome (MetS) in postmenopausal women of normal weight remain limited, this study aimed to explore the association between parity and MetS among Chinese normal-weight postmenopausal women. METHODS In total, 776 normal-weight undiagnosed type 2 diabetes postmenopausal women who visited the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University for a routine health check-up between 1 January 2017 and 31 December 2019 were included in the cross-sectional study. All individuals had fully completed information records encompassing standardized electronic medical records, physical examinations, and biochemical measurements. Metabolic health was defined as fewer than 2 parameters of the MetS were present, in combination with normal weight. Continuous variables which were normally distributed were expressed as means and standard deviation. Comparisons among normally distributed continuous variables were made using one-way ANOVA while that among non-normal distribution parameters were made using Kruskal-Wallis. The association between parity and MetS was analyzed using multivariate logistic regression. All of the analyses were performed with SPSS statistical software (Version 23.0, SPSS, Inc., Chicago, IL, USA) and the statistical software package EmpowerStats ( http://www.empowerstats.com , X&Y Solutions, Inc., Boston, MA). RESULTS After adjusting for potential confounding factors including hip circumference, parity was failed to show a significantly relationship with MetS in normal-weight women(P=0.054). Women with a higher parity (≥3) had an increased OR of abdominal obesity, while the OR (95% CI) of the parity 3 group was 2.06 (1.13, 3.77) and that of the parity ≥4 group was 3.08(1.42, 6.66) the P for trend was 0.002 after adjusting for potential confounding factors. No significant differences were detected for other metabolic disorders including high levels of triglycerides (TG), blood pressure, fasting plasma glucose (FPG), and decreased high-density lipoprotein cholesterol (HDL-C) in different parity groups. CONCLUSIONS Higher parity was not associated with a higher risk of MetS in normal weight Chinese postmenopausal women. As for the components of MetS, only waist circumference was associated with multiparity even after controlling for hip circumference.
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Affiliation(s)
- Mengte Shi
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China
| | - Xinhe Zhou
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China
| | - Chao Zheng
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China.
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
| | - Youjin Pan
- Department of Endocrinology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109, Xueyuanxi Road, Wenzhou, Zhejiang, 325000, China.
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11
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Jasienska G. Costs of reproduction and ageing in the human female. Philos Trans R Soc Lond B Biol Sci 2020; 375:20190615. [PMID: 32951546 PMCID: PMC7540952 DOI: 10.1098/rstb.2019.0615] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 12/27/2022] Open
Abstract
Evolutionary theories of ageing point to reproduction as a significant factor to consider when asking why ageing occurs and why there is inter-individual variation in its progression. Reproduction in human females is costly, in terms of energy, nutrients and metabolic adjustments. Thus, it is expected that women who experienced high reproductive effort resulting from multiple reproductive events will age faster. However, the evidence for long-term negative effects of reproduction is not conclusive. The lack of understanding of whether there are trade-offs between reproduction and ageing in women is partly due to methodological challenges. The costs of reproduction are often calculated based only on parity, while other elements contributing to these costs (e.g. breastfeeding, timing of reproduction) are neglected, which may significantly underestimate the total costs and obscure the all-important inter-individual variation in such costs. Costs must be evaluated in relation to individual characteristics, including developmental conditions, nutritional status and social support that a mother receives during reproduction. Furthermore, ageing and health must be assessed based on comprehensive markers rather than arbitrarily assembled variables. Finally, longitudinal rather than cross-sectional studies and new statistical approaches are needed to reveal how much of a decline in health and progressing ageing can actually be attributed to past reproductive processes. This article is part of the theme issue 'Evolution of the primate ageing process'.
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Affiliation(s)
- Grazyna Jasienska
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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12
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Tørris C, Bjørnnes AK. Duration of Lactation and Maternal Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:E2718. [PMID: 32899507 PMCID: PMC7551509 DOI: 10.3390/nu12092718] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/29/2020] [Accepted: 09/03/2020] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death of women across all ages, and targeting modifiable risk factors, such as those comprised in metabolic syndrome (MetS) (e.g., waist circumference, lipid profile, blood pressure, and blood glucose), is of great importance. An inverse association between lactation and CVD has been suggested, and lactation may decrease the risk of MetS. This systematic review and meta-analysis examined how lactation may affect the development and prevalence of MetS in women. A literature search was performed using Cinahl, Embase, Web of Science, and PubMed. A total of 1286 citations were identified, and finally, ten studies (two prospective and eight cross-sectional) were included. Seven studies (two prospective and five cross-sectional) revealed associations between lactation and MetS, suggesting that breastfeeding might prevent or improve metabolic health and have a protective role in MetS prevention. This protective role might be related to the duration of lactation; however, a lack of controlling for potential confounders, such as parity, might inflict the results. The pooled effect was non-conclusive. Additional research is required to further explore the duration of lactation and its potential role in improving or reversing MetS and its components.
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Affiliation(s)
- Christine Tørris
- Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
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13
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Pacyga DC, Henning M, Chiang C, Smith RL, Flaws JA, Strakovsky RS. Associations of Pregnancy History with BMI and Weight Gain in 45-54-Year-Old Women. Curr Dev Nutr 2020; 4:nzz139. [PMID: 31893261 PMCID: PMC6933615 DOI: 10.1093/cdn/nzz139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/22/2019] [Accepted: 12/03/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Midlife women have a higher risk of cardiometabolic disease than younger women, but the lifelong biological/lifestyle factors responsible for this increase are unclear. OBJECTIVES We investigated whether pregnancy history is a risk factor for midlife overweight/obesity and evaluated potential hormonal mechanisms. METHODS The Baltimore Midlife Women's Health Study, a prospective cohort, recruited 772 women aged 45-54 y. Women reported pregnancy characteristics via questionnaires, trained staff measured weight/height to calculate midlife BMI, and serum hormones were assessed by ELISA. Logistic regression models assessed associations of pregnancy history with risk of midlife overweight/obesity and BMI gain since age 18. We additionally explored whether associations differed by menopausal status, and whether midlife hormones mediated relationships of pregnancy history and midlife BMI. RESULTS These premenopausal or perimenopausal women were 66% Caucasian/White and 30% African American/Black, with a median of 2 live births (range: 0-11) and median age at first birth of 27 y (range: 12-46 y). Women with 0 and ≥2 live births had lower odds of overweight/obesity than those with 1 birth (OR = 0.47; 95% CI: 0.23, 0.96; P = 0.04, and OR = 0.58; 95% CI: 0.35, 0.95; P = 0.03, respectively). Women with ≥2 live births also had lower odds of BMI gain than those with 1 birth (OR = 0.66; 95% CI: 0.41, 1.06; P = 0.08). Furthermore, women who were older at their first birth had lower odds of overweight/obesity (OR = 0.96; 95% CI: 0.92, 1.00; P = 0.03) and BMI gain (OR = 0.97; 95% CI: 0.93, 1.00; P = 0.06). Number of pregnancies and age at last pregnancy were not associated with midlife overweight/obesity or BMI gain. Associations did not differ by menopausal status and were not explained by midlife hormones. CONCLUSIONS Earlier childbirth and having 1 child increased women's risk of midlife overweight/obesity and BMI gain since age 18. Additional studies should focus on women's childbearing years as a critical determinant of midlife metabolic health.
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Affiliation(s)
- Diana C Pacyga
- Department of Food Science and Human Nutrition
- Institute for Integrative Toxicology
- Department of Epidemiology and Biostatistics
| | - Melissa Henning
- Department of Food Science and Human Nutrition
- Lyman Briggs College, Michigan State University, East Lansing, MI, USA
| | | | - Rebecca L Smith
- Department of Pathobiology, University of Illinois, Urbana-Champaign, IL, USA
| | | | - Rita S Strakovsky
- Department of Food Science and Human Nutrition
- Institute for Integrative Toxicology
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14
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Li C, Binongo JN, Kancherla V. Effect of Parity on Pregnancy-Associated Hypertension Among Asian American Women in the United States. Matern Child Health J 2019; 23:1098-1107. [PMID: 31197548 DOI: 10.1007/s10995-019-02746-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Pregnancy-associated hypertension (PAH) includes gestational hypertension, preeclampsia and eclampsia. Although a protective effect of multi-parity on PAH has been reported in previous studies, the association has not been examined among Asian American women in the U.S. METHODS Using data from 2014 U.S. National Vital Statistics System, we examined the prevalence of PAH among Asian American women who had singleton live births (N = 235,303), and its association with parity (number of previous pregnancies including live births and fetal deaths) controlling for potential confounders. We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CI) using multivariable logistic regression analysis. RESULTS Overall, 2.72% (95% CI 2.66%, 2.79%) of Asian American women were recorded to have PAH during pregnancy. Parity was inversely associated with PAH in our study, where Asian American women who had 1-2 and 3 or more previous pregnancies had significantly lower odds of PAH (aOR 0.61, 95% CI 0.58, 0.65; and aOR 0.62, 95% CI 0.57, 0.68, respectively) compared to nulliparous women, after controlling for potential confounders. CONCLUSIONS Recent U.S. vital statistics data revealed that nulliparity is significantly associated with PAH among Asian American women. Future studies should identify specific factors that are associated with PAH and factors contributing to disparities in PAH risk among Asian American women.
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Affiliation(s)
- Chaohua Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA.
| | - Jose N Binongo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Vijaya Kancherla
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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15
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Sun K, Lin D, Feng Q, Li F, Qi Y, Huang C, Feng W, Yang C, Yan L, Ren M. Parity is associated with albuminuria and chronic kidney disease: a population-based study. Aging (Albany NY) 2019; 11:11030-11039. [PMID: 31790364 PMCID: PMC6932874 DOI: 10.18632/aging.102507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/18/2019] [Indexed: 01/05/2023]
Abstract
Background and aims: Epidemiological studies have shown that increasing parity is associated with risk of hypertension and diabetes in parous women. However, the relationship between the parity degree with chronic kidney disease (CKD) is still unknown. Results: Parous women with higher parity had increased age, body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, fasting insulin and decreased high-density lipoprotein cholesterol, eGFR and education levels. Compared with women with one-child birth, those with more than two-child births had greater prevalence of increased urinary albumin excretion (odds ratios [ORs] 1.53, 95% confidence intervals [CI], 1.03 - 2.28) and CKD (ORs 1.79, 95% CI, 1.24 - 2.58) after multiple adjustments. In dose-response analysis, a nonlinear relationship of parity degree with albuminuria and CKD was detected. Conclusion: Parity is associated with higher prevalence of albuminuria and CKD in middle-aged and elderly Chinese women. Methods: We conducted a community-based study in 6,946 women to investigate the association of parity with albuminuria and CKD. Increased urinary albumin excretion was defined as albumin-to-creatinine ratio (ACR) greater or equal than 30 mg/g. CKD was defined as estimated glomerular filtration rate (eGFR) less than 60 mL/min per 1.73 m² or presence of albuminuria.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Qiling Feng
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Chulin Huang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Wanting Feng
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Chuan Yang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, People's Republic of China
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Stamatelopoulos K, Apostolakis M, Augoulea A, Paschou SA, Armeni E, Panoulis K, Bakas P, Georgiopoulos G, Kaparos G, Rizos D, Lambrinoudaki I. Predictors of incident hypertension in healthy non-diabetic postmenopausal women with normal renal function. Gynecol Endocrinol 2019; 35:1063-1066. [PMID: 31220965 DOI: 10.1080/09513590.2019.1630607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Introduction: We aimed to investigate the incidence of hypertension and to identify potential risk factors in healthy, non-diabetic recently postmenopausal Greek women with normal renal function.Patients and methods: This retrospective cohort study evaluated 141 recently postmenopausal women at baseline and annually thereafter (follow-up time: 1 to 8 years). Blood samples were obtained, and ultrasound evaluations were performed at baseline. A detailed medical history, anthropometric parameters, blood pressure and cardiovascular risk factors were recorded for every woman at each visit. Incident hypertension was defined as the first occurrence of office systolic or diastolic blood pressure, measured at 2 different visits within 2 months or history of initiation of antihypertensive medication.Results: Incident hypertension was diagnosed in 30 out of 141 women (21.3%). The median time to incident hypertension was 3.5 years. Adiposity, elevated cholesterol and triglyceride levels, insulin resistance and parity were positively associated with incident hypertension. In multivariate analysis, however, obesity and insulin resistance were the only statistically significant variables associated with more than 3-fold and 2-fold respectively increased risk of incident hypertension (HOMA-IR, O.R = 1.988, p-value =.043; obesity, O.R = 3.746, p-value =.019).Conclusion: A significant proportion of women entering the menopause present incident hypertension and this is mostly associated with obesity and insulin resistance.
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Affiliation(s)
- Kimon Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michail Apostolakis
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula A Paschou
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Panoulis
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Bakas
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Georgiopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Kaparos
- Hormonal and Biochemical Laboratory, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Rizos
- Hormonal and Biochemical Laboratory, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Sun K, Lin D, Qiling F, Li F, Qi Y, Feng W, Ren M, Yan L, Liu D. Number of parity is associated with low-grade albuminuria in middle-aged and elderly Chinese women. BMC WOMENS HEALTH 2019; 19:117. [PMID: 31590639 PMCID: PMC6781324 DOI: 10.1186/s12905-019-0814-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 09/06/2019] [Indexed: 01/13/2023]
Abstract
Background Women with a higher number of pregnancies have a higher risk of developing cardiovascular diseases. Subtle fluctuations in albumin excretion could be related to pathophysiologic changes in the vascular system. We aimed to investigate the possible association of parity with low-grade albuminuria. Methods We conducted a community-based study in 6495 women aged 40 years or older. Low-grade albuminuria was defined according to the highest quartile of urine albumin-to-creatinine ratio in participants free of micro- or macro-albuminuria. Results Parous women with a higher number of pregnancies had increased age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), fasting plasma glucose (FPG), and fasting insulin, as well as decreased high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR) levels, and proportion of menopause. The prevalence of low-grade albuminuria in parous women gradually increased with parity number. Compared with women with one childbirth, those with more than two childbirths were independently associated with a higher prevalent low-grade albuminuria (odds ratios [ORs] 1.41, 95% confidence interval [CI], 1.09–1.81) after multiple adjustments. In subgroup analysis after multiple adjustments, significant relation between parity number and prevalent low-grade albuminuria was detected in subjects age 55 years or older. Conclusion Number of parity is associated with prevalent low-grade albuminuria in middle-aged and elderly Chinese women without micro- or macro-albuminuria.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Feng Qiling
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Wanting Feng
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
| | - Dan Liu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No.107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
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Suzuki W, Wuren, Kuriki K. Associations between family factors and body weight gain from 20 years old. BMC WOMENS HEALTH 2019; 19:33. [PMID: 30755194 PMCID: PMC6373019 DOI: 10.1186/s12905-019-0719-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/16/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although family factors can greatly impact adult health, little is known about the extent to which family factors are related to body weight gain (BWG) in adulthood. This study aimed to examine the associations between family factors and BWG from 20 years old. METHODS Among the 6395 possible participants aged 35 to 79 years, 2884 men and 2171 women were eligible for the study. Present body mass indexes (BMI) were measured, and family factors and body weight from 20 years old (i.e., BMI_20yr) were collected using a self-administered questionnaire. The differences between BMI and BMI_20yr were calculated, and those with increases of BMI ≥2.5 kg/m2 (i.e., ≥7.5 and 6.0 kg in men and women, respectively) were defined as 'cases' of BWG. Using a multiple logistic regression analysis, the odds ratios (ORs, 95% confidence intervals [CIs] and p for trend) were estimated. RESULTS In the men, no association was found. In the women, the ORs were 0.31, 1.00 and 0.77 (0.17-0.58, [reference], and (0.52-1.29), p < 0.001) as per their marital status: unmarried, married, and bereaved/divorced, respectively. Although no association was found with family structure (i.e., single, couple, and two and three generations living together), for familial relationships, the ORs were 1.00, 1.11 and 1.86 ([reference], 0.85-1.46, and 1.25-2.79, p < 0.01) for 'good', 'somewhat good', and 'not so good/not good', respectively. Even if a 'case' of BWG was ≥3.5 kg/m2, nearly the same risks remained. CONCLUSION Marital status and family relationships were associated with decreased and increased risks of BWG only in the female participants. Family factors should be considered when advising women on body weight control.
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Affiliation(s)
- Wakako Suzuki
- School of Nursing, University of Shizuoka, 2-2-1 Oshika, Suruga-ku, Shizuoka, 422-8021, Japan.,Laboratory of Public Health, Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan
| | - Wuren
- Laboratory of Public Health, Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health, Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan.
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Gomes CS, Pirkle CM, Barbosa JFS, Vafaei A, Câmara SMA, Guerra RO. Age at First Birth, Parity and History of Hysterectomy Are Associated to Frailty Status: Cross-Sectional Analysis from the International Mobility in Aging Study -Imias. J Cross Cult Gerontol 2018; 33:337-354. [DOI: 10.1007/s10823-018-9360-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Lee Y, Lee HN, Kim SJ, Koo J, Lee KE, Shin JE. Higher parity and risk of metabolic syndrome in Korean postmenopausal women: Korea National Health and Nutrition Examination Survey 2010-2012. J Obstet Gynaecol Res 2018; 44:2045-2052. [PMID: 30058110 DOI: 10.1111/jog.13766] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 06/29/2018] [Indexed: 01/17/2023]
Abstract
AIM We sought to examine whether parity is associated with higher incidence of metabolic syndrome in postmenopausal women. METHODS We conducted a cross-sectional study on 4098 Korean postmenopausal women by using nationally representative data from the Korea National Health and Nutrition Examination Survey 2010-2012. Multivariate logistic regression was performed to evaluate the relationship between parity and metabolic syndrome, with adjustment for potential confounding variables. RESULTS The rate of metabolic syndrome was significantly higher with increasing number of parity, with dose-response relationship in univariate analysis (P <0.001). In addition, higher parity (≥3 live births) was associated with more prevalence of all components of metabolic syndrome compared with two live births (parity 2 vs 3 vs ≥4: 5.5 vs 12.1 and 14.4%, respectively; P < 0.001). However, after adjusting for demographic, socioeconomic, lifestyle and reproductive factors, we found that only higher parity was significantly associated with metabolic syndrome compared with two live births, and failed to show a dose-dependent relationship (parity 2 vs 3 vs ≥4: odds ratio 1 vs 1.404 vs 1.379, respectively; P = 0.043). We also proved that among the components of metabolic syndrome, only waist circumference had a significant positive relationship with parity in a multivariable adjusted model (parity 2 vs 3 vs ≥4: odds ratio 1 vs 1.559 vs 1.656, respectively; P < 0.001). CONCLUSION Higher parity was independently associated with a higher risk of metabolic syndrome in postmenopausal women.
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Affiliation(s)
- Young Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hae Nam Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sa Jin Kim
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jahyun Koo
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kyung Eun Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Eun Shin
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Jung CH, Mok JO, Chang SW, Lee B, Jang JH, Kang S, Jung SH. Differential impacts of serum vitamin D levels and age at menarche on metabolic syndrome in premenopausal and postmenopausal women: findings from the Korea national cohort. Nutr Res 2018; 55:21-32. [DOI: 10.1016/j.nutres.2018.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 04/01/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
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Lee WJ, Yoon JW, Lee JH, Kwag BG, Chang SH, Choi YJ. Effects of Age at First Childbirth and Other Factors on Central Obesity in Postmenopausal Women: The 2013-2015 Korean National Health and Nutrition Examination Survey. Korean J Fam Med 2018; 39:155-160. [PMID: 29788703 PMCID: PMC5975985 DOI: 10.4082/kjfm.2018.39.3.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/24/2017] [Accepted: 05/23/2017] [Indexed: 11/08/2022] Open
Abstract
Background Waist circumference is one of the key components of metabolic syndrome. Recent studies demonstrated that the reproductive profile was associated with metabolic syndrome in postmenopausal women. This study focused on the association between central obesity and age at first childbirth. It also considered other factors associated with central obesity in postmenopausal women. Methods This study was based on the 2013–2015 Korean National Health and Nutrition Examination Survey and involved 3,143 naturally postmenopausal women. These women were divided into three groups according to their age at first childbirth: 19 years or younger (n=252), 20–29 years (n=2,695), and 30 years or older (n=196). Multivariate analysis using logistic regression was performed to evaluate the effects of various reproductive factors, including other confounding factors. Results During adjustment for confounding factors, in the early age at first childbirth group, odds ratios (95% confidence intervals) for central obesity decreased. In the final model, younger age at first childbirth was not significantly related to central obesity (waist circumference more than 85 cm) in naturally postmenopausal women after adjusting for other confounding factors. Conclusion Younger age at first childbirth was not significantly associated with central obesity after adjustment for confounding factors.
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Affiliation(s)
- Wang Jin Lee
- Department of Family Medicine, Green Hospital, Seoul, Korea
| | - Jung Won Yoon
- Department of Obstetrics and Gynecology, Green Hospital, Seoul, Korea
| | - Joo Ha Lee
- Department of Family Medicine, Green Hospital, Seoul, Korea
| | | | - Shin Hae Chang
- Department of Family Medicine, Green Hospital, Seoul, Korea
| | - Yu Jin Choi
- Department of Family Medicine, Green Hospital, Seoul, Korea
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Wang Q, Xu L, Li J, Sun L, Qin W, Ding G, Zhu J, Zhang J, Yu Z, Xie S. Association of Anthropometric Indices of Obesity with Hypertension in Chinese Elderly: An Analysis of Age and Gender Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040801. [PMID: 29671813 PMCID: PMC5923843 DOI: 10.3390/ijerph15040801] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 11/16/2022]
Abstract
This study aims to explore the association of anthropometric indices of obesity with hypertension in Chinese elderly and its possible gender and age differences. A total of 7070 adults age 60 or older were interviewed in a cross-sectional study conducted in 2017. Anthropometric indices for each participant were measured by using standard methods of trained doctoral/master students. We performed two binary logistic regression models to examine the association of the nine different anthropometric indices and hypertension by gender. Lastly, analyses were performed in two steps stratified for age. Comparing individuals with and without hypertension, there were statistically significant differences in anthropometric indices except height, a body shape index (ABSI), and hip index (HI) in males; and except height in females. There were gender differences in the relationship between anthropometric indices and the prevalence of hypertension in Chinese older adults. After stratification by age, the associations of all anthropometric indices became weaker, disappeared, or even went in the opposite direction. Furthermore, body mass index (BMI) in men (except individuals older than 80) and hip circumference (HC) in women showed a significant impact on the risk of hypertension. The association of anthropometric indices of obesity with hypertension in Chinese elderly differ by gender and age. These findings indicate a need to develop gender-specific strategies for the male and female elderly in the primary and secondary prevention of hypertension.
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Affiliation(s)
- Qian Wang
- School of Public Health, Shandong University, Jinan 250012, China.
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Long Sun
- School of Public Health, Shandong University, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Wenzhe Qin
- School of Public Health, Shandong University, Jinan 250012, China.
| | - Gan Ding
- School of Public Health, Shandong University, Jinan 250012, China.
| | - Jing Zhu
- School of Public Health, Shandong University, Jinan 250012, China.
| | - Jiao Zhang
- School of Public Health, Shandong University, Jinan 250012, China.
| | - Zihang Yu
- School of Public Health, Shandong University, Jinan 250012, China.
| | - Su Xie
- School of Public Health, Shandong University, Jinan 250012, China.
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Rosendaal NTA, Alvarado B, Wu YY, Velez MP, da Câmara SMA, Pirkle CM. Adolescent Childbirth Is Associated With Greater Framingham Risk Scores for Cardiovascular Disease Among Participants of the IMIAS (International Mobility in Aging Study). J Am Heart Assoc 2017; 6:e007058. [PMID: 29092844 PMCID: PMC5721784 DOI: 10.1161/jaha.117.007058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/11/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous studies observe associations between lifetime parity and cardiovascular disease, but relatively fewer investigate age at first childbirth (AFB). Herein, we examine the association of AFB with a summary cardiovascular risk measure (Framingham Risk Score [FRS]). METHODS AND RESULTS As part of the IMIAS (International Mobility in Aging Study), data were collected in 2012 among 1047 women, aged 65 to 74 years, from Canada, Albania, Colombia, and Brazil. FRSs were calculated to describe cardiovascular risk profiles, and linear regression analyses were performed, adjusting for early life and socioeconomic variables. Women with an AFB of <20 years were compared with women with an AFB of 20 to 24, 25 to 29, and ≥30 years, as well as nulliparous women. We also compared FRS between combinations of AFB and parity categories: nulliparous women, parity 1 to 3 combined with AFB <20 years, parity ≥4 with AFB <20 years, parity 1 to 3 with AFB ≥20 years, and parity ≥4 with AFB ≥20 years. Women with an AFB of <20 years had a higher mean FRS compared with all other AFB groups. Compared with the lowest AFB risk group (25-29 years), women with an AFB of <20 years had a 5.8-point higher mean FRS (95% confidence interval, 3.4-8.3 points). Nulliparous women presented the lowest mean FRS in all analyses. The analysis comparing combinations of AFB and parity categories showed no meaningful differences in FRS between women who had 1 to 3 childbirths and those who had ≥4 childbirths within the stratum of AFB <20 years, and in the stratum of AFB ≥20 years. CONCLUSIONS Our analyses suggest that nulliparity and AFB, rather than increasing parity, drive the association with cardiovascular disease risk.
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Affiliation(s)
| | - Beatriz Alvarado
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
| | - Maria P Velez
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | - Saionara M Aires da Câmara
- Faculty of Health Sciences of Trairí, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI
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Choi SR, Kim YM, Cho MS, Kim SH, Shim YS. Association Between Duration of Breast Feeding and Metabolic Syndrome: The Korean National Health and Nutrition Examination Surveys. J Womens Health (Larchmt) 2017; 26:361-367. [DOI: 10.1089/jwh.2016.6036] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Se Rin Choi
- Department of Pediatrics, Hallym University, College of Medicine, Seoul, Korea
| | - Yong Min Kim
- Department of Pediatrics, Hallym University, College of Medicine, Seoul, Korea
| | - Min Su Cho
- Department of Pediatrics, Hallym University, College of Medicine, Seoul, Korea
| | - So Hyun Kim
- Department of Pediatrics, Hallym University, College of Medicine, Seoul, Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University, College of Medicine, Seoul, Korea
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Xu B, Chen Y, Xiong J, Lu N, Tan X. Association of Female Reproductive Factors with Hypertension, Diabetes and LQTc in Chinese Women. Sci Rep 2017; 7:42803. [PMID: 28211485 PMCID: PMC5314360 DOI: 10.1038/srep42803] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/13/2017] [Indexed: 02/05/2023] Open
Abstract
The association of female reproductive factors (FRFs) with cardiovascular risk factors among different population was variable and inconsistent. The objective of this study was to examine the association between FRFs and hypertension, type 2 diabetes mellitus (DM), and long heart-rate-corrected QT interval (LQTc) in Chinese post-menopausal women (Post-MW). A total of 8046 Post-MW from the China Chaoshan Biobank Cohort Study were included for analysis. Logistic regression and general linear regression models were used to estimate the association between FRFs and hypertension, DM, and LQTc. Compared with women with 0 or 1 live birth, increasing risk of hypertension (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.16-1.96), DM (OR, 1.65; 95% CI, 1.22-2.22), and LQTc (OR, 1.45; 95% CI, 1.01-2.09) were observed in women who had five or more live births. Further analysis demonstrated that the association between parity and hypertension, DM, and LQTc was mediated by lifestyle and dyslipidemia. Women with more live births had increased body mass index and waist circumstance, and were inclined to consume more salty food, animal fat, and alcohol, but less meat, vegetable, fish, plant oil, and tea, compared with that had fewer live births (all P < 0.05).
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Affiliation(s)
- Bayi Xu
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
- Shantou University Medical College, Shantou, 515041, Guangdong Province, China
| | - Yequn Chen
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
| | - Jianping Xiong
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
| | - Nan Lu
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
| | - Xuerui Tan
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
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Association between maternal age at childbirth and metabolic syndrome in postmenopausal women: Korea National Health and Nutrition Examination Survey 2010 to 2012. Menopause 2017; 24:196-202. [DOI: 10.1097/gme.0000000000000740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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He SJ, Chan C, Xie ZD, Shi D, Hu XB, Li HY, Wang D, Wang MZ, Bai YN. The relationship between serum uric acid and metabolic syndrome in premenopausal and postmenopausal women in the Jinchang Cohort. Gynecol Endocrinol 2017; 33:141-144. [PMID: 27558970 DOI: 10.1080/09513590.2016.1214261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The aim of the study was to explore the association between serum uric acid (SUA) and metabolic syndrome (MetS) in premenopausal and postmenopausal women in the Jinchang Cohort. We studied 3808 female Jinchuan Nonferrous Metals Corporation workers aged 40-60 years. Cohort data from epidemiological surveys and medical exams were used. MetS was defined using the 2009 Joint Interim Society criteria. The relationship between SUA and MetS was evaluated using multiple logistic regression after adjusting for potential confounders. MetS and hyperuricemia were more prevalent in postmenopausal women than premenopausal ones (35.3% versus 15.2% and 9.2% versus 4.2%, respectively). Premenopausal and postmenopausal women with hyperuricemia had 2.81 (95% CI: 1.72-4.61) and 2.10 (95% CI: 1.44-3.08), respectively, times the odds of having MetS than their counterparts without hyperuricemia. Even within normal SUA quartiles, only premenopausal women in the highest and second-highest quartile had 3.57 (95% CI: 2.24-5.68) and 2.78 (95% CI: 1.71-4.50), respectively, times the odds of having MetS than those in the lowest quartile. Even in the normal range, the odds ratios for MetS increased gradually according to SUA levels in all women (Ptrend < 0.001). In conclusion, there was a significant correlation between SUA levels and MetS, and the association was stronger in premenopausal women than postmenopausal ones.
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Affiliation(s)
- Shi-Jiao He
- a Department of Epidemiology and Biostatistics , School of Public Health, Lanzhou University , Lanzhou , Gansu , China
| | - Cynthia Chan
- b School of Public Health, Yale University , New Haven , CT , USA , and
| | - Zhi-Dong Xie
- a Department of Epidemiology and Biostatistics , School of Public Health, Lanzhou University , Lanzhou , Gansu , China
| | - Dian Shi
- a Department of Epidemiology and Biostatistics , School of Public Health, Lanzhou University , Lanzhou , Gansu , China
| | - Xiao-Bin Hu
- a Department of Epidemiology and Biostatistics , School of Public Health, Lanzhou University , Lanzhou , Gansu , China
| | - Hai-Yan Li
- c Jinchuan Workers' Hospital , Jinchang , Gansu , China
| | - Dennis Wang
- b School of Public Health, Yale University , New Haven , CT , USA , and
| | - Min-Zhen Wang
- a Department of Epidemiology and Biostatistics , School of Public Health, Lanzhou University , Lanzhou , Gansu , China
| | - Ya-Na Bai
- a Department of Epidemiology and Biostatistics , School of Public Health, Lanzhou University , Lanzhou , Gansu , China
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Klingberg S, Brekke HK, Winkvist A, Engström G, Hedblad B, Drake I. Parity, weight change, and maternal risk of cardiovascular events. Am J Obstet Gynecol 2017; 216:172.e1-172.e15. [PMID: 27720863 DOI: 10.1016/j.ajog.2016.09.105] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/29/2016] [Accepted: 09/29/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND High parity has been suggested to increase risk of maternal cardiovascular disease independent of body mass index measured after childbearing. Pregnancy is, however, associated with persistent weight gain and metabolic changes that, independent of parity, increase the risk of cardiovascular disease. It could therefore be questioned if high parity independently increases the risk of cardiovascular disease or if this association may be confounded, mediated, or modified by other parity-related factors. OBJECTIVE We sought to investigate the association between parity and risk of cardiovascular disease, and secondary outcomes in terms of myocardial infarction and cerebral infarction, with particular focus on potential mediation by anthropometric measures and effect modification by lactation. STUDY DESIGN We used data from 16,515 female participants (age 44.5-73.6 years) of the population-based Malmö Diet and Cancer Study with baseline examination from 1991 through 1996. The Malmö Diet and Cancer Study was followed up throughout 2010, with a median follow-up of 15.8 years. We used Cox proportional hazards model to examine the association between parity and cardiovascular disease. RESULTS Adjusted for age and other potential confounders, grand multiparous women (≥5 children) had an increased risk of cardiovascular disease (hazard ratio, 1.60; 95% confidence interval, 1.20-2.14), myocardial infarction (hazard ratio, 1.68; 95% confidence interval, 1.15-2.45), and cerebral infarction (hazard ratio, 1.74; 95% confidence interval, 1.18-2.58) compared to women with 2 children. Additional adjustment for baseline body mass index and weight change since age 20 years attenuated the risk, but the increased risk for cardiovascular disease (hazard ratio, 1.38; 95% confidence interval, 1.02-1.87) and myocardial infarction (hazard ratio, 1.53; 95% confidence interval, 1.04-2.26) in grand multiparous women remained significant. Models stratified by lactation time showed that risk was only raised in grand multiparous women who had a mean lactation time of <4 mo/child. In sensitivity analyses excluding women with a history of diabetes at baseline, risk estimates for grand multiparous women became nonsignificant in the full model. CONCLUSION Part of the increased risk of cardiovascular disease and myocardial infarction in grand multiparous women seems to be mediated by weight gain and potentially by higher likelihood of type 2 diabetes mellitus. Lactation may modify the increased risk of grand multiparity in that longer duration might offset the cardiovascular disease risk.
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Affiliation(s)
- Sofia Klingberg
- Department of Public Health and Community Medicine, Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Hilde K Brekke
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Engström
- Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Bo Hedblad
- Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Isabel Drake
- Diabetes and Cardiovascular Disease-Genetic Epidemiology, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
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Vladutiu CJ, Siega-Riz AM, Sotres-Alvarez D, Stuebe AM, Ni A, Tabb KM, Gallo LC, Potter JE, Heiss G. Parity and Components of the Metabolic Syndrome Among US Hispanic/Latina Women: Results From the Hispanic Community Health Study/Study of Latinos. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 2016; 9:S62-9. [PMID: 26908862 DOI: 10.1161/circoutcomes.115.002464] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Physiological adaptations occurring across successive pregnancies may increase the risk of adverse cardiovascular health outcomes in later life. METHODS AND RESULTS The association between parity and metabolic syndrome was examined among 7467 Hispanic/Latina women of diverse backgrounds, aged 18 to 74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from 2008 to 2011. Metabolic syndrome components were defined according to American Heart Association/National Heart, Lung, and Blood Institute criteria and included abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol, high blood pressure, and elevated fasting glucose. Logistic regression models estimated odds ratios (ORs) adjusting for sociodemographic, behavioral, and reproductive characteristics. At HCHS/SOL baseline, women reported none (21.1%), 1 (19.9%), 2 (25.7%), 3 (18.6%), 4 (8.8%), and ≥ 5 (5.9%) live births. When compared with women with 1 birth, those with 4 births had the highest odds of abdominal obesity (OR, 2.0; 95% confidence interval, 1.5-2.8) and overall metabolic syndrome (OR, 1.4; 95% confidence interval, 1.0-2.0) and those with ≥ 5 births had the highest odds of low high-density lipoprotein cholesterol (OR, 1.5; 95% confidence interval, 1.2-2.0) and elevated fasting glucose (OR, 1.6; 95% confidence interval, 1.1-2.4), after adjusting for age, background, education, marital status, income, nativity, smoking, physical activity, menopause, oral contraceptive use, hormone therapy, and field center. Further adjustment for percent body fat attenuated these associations. No associations were observed between parity and elevated triglycerides or high blood pressure. CONCLUSIONS Higher parity is associated with an increased prevalence of selected components of the metabolic syndrome among Hispanic/Latina women in the US. High parity among Hispanics/Latinas with a high prevalence of abdominal obesity suggests high risk for metabolic dysregulation.
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Affiliation(s)
- Catherine J Vladutiu
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.).
| | - Anna Maria Siega-Riz
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Daniela Sotres-Alvarez
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Alison M Stuebe
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Andy Ni
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Karen M Tabb
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Linda C Gallo
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - JoNell E Potter
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
| | - Gerardo Heiss
- From the Department of Obstetrics and Gynecology, School of Medicine, (C.J.V., A.M.S.), Department of Epidemiology, Gillings School of Global Public Health (C.J.V., A.M.S.-R., G.H.), Department of Nutrition, Gillings School of Global Public Health (A.M.S.-R.), Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health (D.S.-A., A.N.), Department of Maternal and Child Health, Gillings School of Global Public Health (A.M.S.), University of North Carolina, Chapel Hill; School of Social Work, University of Illinois at Urbana-Champaign (K.M.T.); Department of Psychology, San Diego State University, CA (L.C.G.); and Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, FL (J.E.P.)
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Li P, Shan Z, Zhou L, Xie M, Bao W, Zhang Y, Rong Y, Yang W, Liu L. MECHANISMS IN ENDOCRINOLOGY: Parity and risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Endocrinol 2016; 175:R231-45. [PMID: 27334332 DOI: 10.1530/eje-16-0321] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 06/21/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Epidemiologic studies regarding the association between parity and risk of type 2 diabetes have yielded inconsistent results. Therefore, we performed a systematic review and dose-response meta-analysis to determine the relation between parity and type 2 diabetes risk. METHODS We searched PubMed and Embase for published epidemiologic studies that assessed the relation between parity and risk of type 2 diabetes up to 31 March 2016. A dose-response random-effects model was used to combine study-specific relative risks (RRs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. RESULTS Seven cohort studies, 1 case-control study and 9 cross-sectional studies including 296 923 participants were eligible for inclusion. The combined RR for the highest versus lowest category of parity indicated a 54% increment in type 2 diabetes risk (95% CI: 29-83%). In the cubic spline model, a nonlinear association was found between parity and risk of type 2 diabetes (P = 0.02 for nonlinearity). Compared with nulliparous women, the estimated RR (95% CI) of type 2 diabetes for women with one to seven children was 1.01 (0.96-1.07), 1.08 (1.00-1.16), 1.20 (1.12-1.30), 1.32 (1.22-1.42), 1.37 (1.27-1.48), 1.39 (1.26-1.52) and 1.39 (1.23-1.57) respectively. CONCLUSIONS Higher parity is significantly associated with an increased risk of type 2 diabetes. Further studies are warranted to fully adjust for the potential confounders and explore the causality between parity and type 2 diabetes risk.
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Affiliation(s)
- Peiyun Li
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhilei Shan
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Li Zhou
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Manling Xie
- Department of Pathology and Laboratory MedicineEmory University School of Medicine, Atlanta, Georgia, USA
| | - Wei Bao
- Department of EpidemiologyCollege of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Yan Zhang
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Ying Rong
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Wei Yang
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Liegang Liu
- Department of Nutrition and Food HygieneHubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China MOE Key Lab of Environment and HealthSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
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Li W, Wang Y, Shen L, Song L, Li H, Liu B, Yuan J, Wang Y. Association between parity and obesity patterns in a middle-aged and older Chinese population: a cross-sectional analysis in the Tongji-Dongfeng cohort study. Nutr Metab (Lond) 2016; 13:72. [PMID: 27795732 PMCID: PMC5081958 DOI: 10.1186/s12986-016-0133-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/17/2016] [Indexed: 12/12/2022] Open
Abstract
Background Higher parity has been implicated as a risk factor for obesity of women. The objective of the study was to examine whether parity was associated with general obesity or abdominal obesity, or both, among middle-aged and older Chinese women. Methods A total of 12,829 Chinese women (mean age: 64.8 years) with at least one live birth were selected from the Dongfeng–Tongji Cohort Study (phase II). We used body mass index to assess general obesity, and waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and waist circumference (WC) to assess abdominal obesity. We used multivariate linear and logistic regression models to investigate the association between parity and obesity. Results The values of all four obesity measures increased with the greater number of live births (P for trend <0.001). After adjustment for potential confounders, women with four or more children had 1.72 times (95 % confidence interval [CI], 1.41–2.10) higher risk of general obesity, and 1.93 (95 % CI, 1.57–2.37), 2.09 (95 % CI, 1.65–3.64) and 1.58 (95 % CI, 1.28–1.94) times risk of abdominal obesity assessed by WHR, WHtR and WC, respectively. Furthermore, we observed an ascending gradient between parity and the three abdominal obesity measures. Conclusions Parity was positively associated with risk of obesity, especially abdominal obesity, in the long term among Chinese women. Electronic supplementary material The online version of this article (doi:10.1186/s12986-016-0133-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wending Li
- School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, 430030 China
| | - Yi Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, 430030 China
| | - Lijun Shen
- School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan, 430030 China ; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Hui Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Bingqing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jing Yuan
- Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China ; Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Relationship between delivery history and health-related quality of life in menopausal South Korean women: The Korea National Health and Nutrition Examination Surveys. Maturitas 2016; 92:24-29. [DOI: 10.1016/j.maturitas.2016.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 06/21/2016] [Accepted: 07/01/2016] [Indexed: 11/18/2022]
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Moradi S, Zamani F, Pishgar F, Ordookhani S, Nateghi N, Salehi F. Parity, duration of lactation and prevalence of maternal metabolic syndrome: a cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2016; 201:70-4. [DOI: 10.1016/j.ejogrb.2016.03.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/20/2016] [Accepted: 03/24/2016] [Indexed: 01/24/2023]
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We JS, Han K, Kwon HS, Kil K. Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea. Medicine (Baltimore) 2016; 95:e3584. [PMID: 27175656 PMCID: PMC4902498 DOI: 10.1097/md.0000000000003584] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.
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Affiliation(s)
- Ji-Sun We
- From the Department of Obstetrics and Gynecology (J-SW, KK), Yeouido St. Mary's Hospital; Department of Medical Statistics (KH), College of Medicine; and Division of Endocrinology and Metabolism (H-SK), Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
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Chung E, Kim Y, Usen O. Associations Between Parity, Obesity, and Cardiovascular Risk Factors Among Middle-Aged Women. J Womens Health (Larchmt) 2016; 25:818-25. [PMID: 26886718 DOI: 10.1089/jwh.2015.5581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Several studies have demonstrated an association between parity and the risk of developing cardiovascular disease (CVD) in middle-aged women; however, some inconsistencies still remain in the literature after accounting for obesity. The purpose of this study was to examine the association between parity and the risk factors of CVD while accounting for current obesity status in middle-aged women. METHOD Data for this study came from the National Health and Nutrition Examination Survey 2007-2012. The final analytic sample included 2024 middle-aged women (40-60 years old). General linear models predicting CVD risk factors based on parity (nulliparous, 1, 2, 3, and ≥4) were established after controlling for study covariates. Least square adjusted means of CVD risk factors and associated 95% confidence intervals were estimated across parity and body mass index (BMI) levels. RESULTS Women with ≥4 parity (8.34%; standard error [SE] = 0.84) showed significantly distinct demographic characteristics and health conditions, including obesity (49.08%; SE = 3.55). There were no significant associations between parity and CVD risk factors after controlling for covariates. Follow-up analyses showed consistent results across parity; however, CVD risk factors were significantly increased with higher BMI levels, regardless of parity status. CONCLUSIONS Our results suggest that parity is not a significant predictor of CVD risk factors in middle-aged women, whereas current overweight or obesity status is more important when explaining the risk of the development of CVD.
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Affiliation(s)
- Eunhee Chung
- Department of Kinesiology and Sport Management, Texas Tech University , Lubbock, Texas
| | - Youngdeok Kim
- Department of Kinesiology and Sport Management, Texas Tech University , Lubbock, Texas
| | - Oduware Usen
- Department of Kinesiology and Sport Management, Texas Tech University , Lubbock, Texas
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Jang M, Lee Y, Choi J, Kim B, Kang J, Kim Y, Cho S. Association between Parity and Blood Pressure in Korean Women: Korean National Health and Nutrition Examination Survey, 2010-2012. Korean J Fam Med 2015; 36:341-8. [PMID: 26634103 PMCID: PMC4666872 DOI: 10.4082/kjfm.2015.36.6.341] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 08/23/2015] [Accepted: 10/07/2015] [Indexed: 01/05/2023] Open
Abstract
Background Pregnancy considerably alters cardiovascular dynamics, and thereby affects the transition of blood pressure after delivery in women. We aimed to analyze the association between parity and blood pressure in Korean adult women. Methods We included 8,890 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We divided the population according to the menopause status and analyzed the association between parity and blood pressure by using multiple regression analysis, and on hypertension, by using logistic regression analysis. Results Systolic and diastolic blood pressures were significantly associated with parity in premenopausal women (β=-0.091 [P<0.001] and β=-0.069 [P<0.001], respectively). In the analysis that excluded women receiving antihypertensive medication, the systolic and diastolic blood pressure of postmenopausal women were significantly associated with parity (β=-0.059 [P=0.022] and β=-0.054 [P=0.044], respectively). Parity was found to prevent hypertension after adjustment for confounders in postmenopausal women (odds ratio, 0.55; 95% confidence interval, 0.310-0.985). Conclusion We found that parity prevented hypertension in Korean women.
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Affiliation(s)
- Miae Jang
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Yeonji Lee
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jiho Choi
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Beomseok Kim
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jayeon Kang
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Yongchae Kim
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
| | - Sewook Cho
- Department of Family Medicine, Inha University School of Medicine, Incheon, Korea
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Chang CJ, Lai MM, Lin CC, Liu CS, Li TC, Li CI, Lin WY. Age at menarche and its association with the metabolic syndrome in Taiwan. Obes Res Clin Pract 2015; 10 Suppl 1:S26-S34. [PMID: 26777792 DOI: 10.1016/j.orcp.2015.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/17/2015] [Accepted: 10/07/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND The average age at menarche in the Taiwanese population is falling. Contrarily, the prevalence of metabolic syndrome (MetS) showed a worldwide increase in the past two decades. The aim of this study was to examine the association between age at menarche and MetS. MATERIALS AND METHODS A total of 3292 women aged 19-91 years old were enrolled in two databases from 2004 to 2008. MetS was defined according to American Heart Association's criteria. Age at menarche was obtained from self-reported questionnaires. Multiple logistic regression analyses were used to estimate the association between age at menarche and MetS with adjustment for potential confounding variables. RESULTS The prevalence of MetS increased with age. After adjusting age, lifestyle status, and reproductive factors as variables, subjects who had menarche at a younger age showed significantly higher risk of MetS. The adjusted odds ratio of having MetS in <12 and 12-14 years old menarche age groups were 1.71 (1.07-2.71) and 1.22 (1.00-1.50), respectively. The significant increase in odds ratio for MetS in early age menarche also reveals a dose-response effect. CONCLUSIONS Early onset of menarche is an important risk factor of MetS and may help identify women at risk of MetS.
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Affiliation(s)
- Chia-Jung Chang
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-May Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Institute of Health Care Administration, Asia University, Taichung, Taiwan
| | - Chiu-Shong Liu
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Kajale NA, Khadilkar AV, Chiplonkar SA, Khadilkar V. Changes in body composition in apparently healthy urban Indian women up to 3 years postpartum. Indian J Endocrinol Metab 2015; 19:477-482. [PMID: 26180762 PMCID: PMC4481653 DOI: 10.4103/2230-8210.159032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Dietary and life style practices differ in postpartum (PP) and nonpregnant Indian women. Effect of these practices on postpartum weight retention (PPWR) and development of cardio-metabolic risk (CMR) has been scarcely studied in urban women. Aims of this study were to (i) compare anthropometry, biochemical parameters and body composition up to 3 years PP (ii) effect of PPWR, dietary fat intake and physical activity on CMR factors. DESIGN Cross-sectional, 300-fullterm, apparently healthy primi-parous women (28.6 ± 3.4 years) randomly selected. 128 women within 7-day of delivery (Group-A), 88 with 1-2 years (Group-B) and 84 with 3-4-year-old-children (Group-C) were studied. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, body composition, at total body (TB), by dual energy X-ray absorptiometry (GE-Lunar DPX) were collected. RESULTS Women at 3-year PP showed higher weight retention (6.5[10] kg) than at 1-year (3.0[7] kg) (median [IQR]). Android fat % (central obesity) increased (P < 0.05) at 1-year PP (47 ± 10.0%) when compared to 1-week PP (44.3 ± 6.7%) and remained elevated at 3-year PP (45.6 ± 10.2%). Regression analysis revealed that at 1-year PP, increase in PPWR (Odd Ratio [OR] 1.8, 95% confidence interval [CI] = [1.2, 2.5], P < 0.001) and inactivity (OR 1.4, 95% CI= (0.97, 2.0), P < 0.1) were predictors for CMR. At 3-year PP, only PPWR was responsible for increase in CMR parameters (OR 1.6, 95% CI = (1.3, 2.3), P < 0.001) and not inactivity (P > 0.1). CONCLUSION Postdelivery, low physical activity and higher PPWR may increase CMR in Indian women.
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Affiliation(s)
- Neha A. Kajale
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Anuradha V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Shashi A. Chiplonkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
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Wu J, Xu G, Shen L, Zhang Y, Song L, Yang S, Yang H, Yuan J, Liang Y, Wang Y, Wu T. Parity and risk of metabolic syndrome among Chinese women. J Womens Health (Larchmt) 2015; 24:602-7. [PMID: 26172999 DOI: 10.1089/jwh.2014.5134] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Studies regarding the effects of parity on metabolic syndrome in later life have produced conflicting results. The purpose of this study was to explore the association between parity and the risk of metabolic syndrome and its components in a population of Chinese women. METHODS A cross-sectional study was performed in a total of 13,358 women (mean age 61.5 years) with at least one live birth from the Dongfeng-Tongji cohort study. Each woman completed baseline questionnaires and received baseline examination, including a physical examination and laboratory tests. Participants were categorized into four groups according to parity (one, two, three, four or more live births). The metabolic syndrome was defined according to the International Diabetes Foundation criteria. Logistic regression was conducted to examine the association between parity and metabolic syndrome, with adjustment of potential confounders. RESULTS In this study sample, the prevalence of metabolic syndrome was 38.6% (5,156 of 13,358). After adjusting for demographic, lifestyle, and reproduction-related factors, women with two, three, or four or more live births had 1.18 times (95% confidence interval [CI], 1.05-1.32), 1.44 times (95% CI, 1.24-1.67), and 1.52 times (95% CI, 1.26-1.83), respectively, higher odds of having metabolic syndrome compared with those with one live birth. Furthermore, parity showed a positive association with waist circumference and a negative association with high-density lipoprotein cholesterol. CONCLUSIONS Multiparity was associated with increasing risk of metabolic syndrome independent of main covariates in this population of Chinese women. The findings suggested that multiparity may be a risk factor for metabolic syndrome.
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Affiliation(s)
- Jing Wu
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Guiqiang Xu
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Lijun Shen
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Yanmei Zhang
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Lulu Song
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Siyi Yang
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Handong Yang
- 3 Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine , Shiyan, China
| | - Jing Yuan
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Yuan Liang
- 4 Department of Social Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Youjie Wang
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Tangchun Wu
- 1 MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
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Sim JH, Chung D, Lim JS, Lee MY, Chung CH, Shin JY, Huh JH. Maternal age at first delivery is associated with the risk of metabolic syndrome in postmenopausal women: from 2008-2010 Korean National Health and Nutrition Examination Survey. PLoS One 2015; 10:e0127860. [PMID: 26010910 PMCID: PMC4444183 DOI: 10.1371/journal.pone.0127860] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/20/2015] [Indexed: 01/20/2023] Open
Abstract
Background Recent cross-sectional studies demonstrated that earlier maternal age at first childbirth is correlated with a higher risk of diabetes in postmenopausal women. In this study, we evaluated whether the age at first delivery is associated with the risk of metabolic syndrome (MetS) in postmenopausal women. Methods A total of 4,261 postmenopausal women aged 45 years or older were analyzed using data generated from Korea National Health and Nutrition Examination Surveys (2008–2010). Subjects were divided into three groups according to the maternal age at first delivery as follows: ≤ 20 years (n=878), 21-25 years (n=2314), and ≥ 26 years (n=1069). Results Approximately 37% of subjects had MetS. The prevalence of MetS showed a gradual increase as maternal age at first delivery decreased (≥ 26 years = 30.9% vs. 21-25 years = 39.9% vs. ≤ 20 years = 50.8%, respectively, p < 0.001). Central obesity indices such as trunk fat mass and waist circumference were significantly higher in the group aged ≤ 20 years than other groups. After adjustments for confounding factors, the odds ratios (ORs) for predicting the presence of MetS increased gradually as first delivery age decreased (≥ 26 years vs. 21-25 years vs. ≤ 20 years: OR [95% CI] = 1 vs. 1.324 [1.118-1.567] vs. 1.641 [1.322-2.036], respectively). Among components of MetS, younger maternal age at first delivery (≤ 20 years) was significantly associated with increased waist circumference (OR [95% CI] = 1.735 [1.41-2.13]), elevated blood pressure (1.261 [1.02-1.57]), high triglyceride (1.333 [1.072-1.659]), and low HDL-cholesterol (1.335[1.084-1.643]). Conclusions Our findings suggest that younger maternal age at first delivery is independently associated with a higher risk of central obesity and MetS in postmenopausal women.
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Affiliation(s)
- Jeong Han Sim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
| | - Dawn Chung
- Department of Obstetrics and Gynecology Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
| | - Jung Soo Lim
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
| | - Mi Young Lee
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
| | - Choon Hee Chung
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
| | - Jang Yel Shin
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
| | - Ji Hye Huh
- Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Gwangwondo, Korea
- * E-mail:
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Cure P, Hoffman HJ, Cure-Cure C. Parity and diabetes risk among hispanic women from Colombia: cross-sectional evidence. Diabetol Metab Syndr 2015; 7:7. [PMID: 25729439 PMCID: PMC4343264 DOI: 10.1186/s13098-015-0001-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 01/17/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The association between parity and type 2 diabetes has been studied in developed countries and in Singapore and Chinese women but not in Hispanics. Herein we evaluated the association between parity (number of live births) with diabetes in a group of Hispanic postmenopausal women from Colombia. RESEARCH DESIGN AND METHODS Herein we evaluated the association between parity and diabetes in a population of 1,795 women from Colombia. Women were divided in birth categories (0 [referent], 1 or 2, 3-5, 6 or > births). Medical history of diabetes and anthropometric characteristics were recorded. Logistic regressions were performed in order to find the association between parity and diabetes in bivariable and multivariable models after controlling for age, body mass index (BMI), waist hip ratio (WHR) and diabetes family history, among other variables. RESULTS In our study, there was an association between parity and diabetes after adjusting for age, BMI and diabetes family history in the multiparous women groups when compared to the women with no births (Referent group) [1-2 births vs. referent OR 5.2 (95 CI 1.2-22.9), 3-5 births vs. referent OR 5.5 (1.3-23.0) and ≥6 births vs. referent OR 7.5 (1.8-31.8), respectively]. The association was maintained in two of the groups in the multivariable analysis [OR 5.0 (1.1-22.9) and 5.3 (1.2-23.5)], for 1 or 2 births and 6 or > births versus 0 births, respectively. Positive diabetes family history and WHR were also associated with an increased risk of diabetes [OR 4.6 (3.0-7.0) and 4.1 (2.0-8.1), respectively]. CONCLUSIONS In postmenopausal Hispanic women, multiparity, as well as a positive family history of diabetes and a high waist-hip ratio were associated with higher diabetes risk.
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Affiliation(s)
- Pablo Cure
- />Children’s National Health System, 111 Michigan Avenue, NW Washington DC, 20010 USA
- />The George Washington University, Washington DC, USA
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Hajiahmadi M, Shafi H, Delavar MA. Impact of parity on obesity: a cross-sectional study in Iranian women. Med Princ Pract 2015; 24:70-4. [PMID: 25402350 PMCID: PMC5588186 DOI: 10.1159/000368358] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 09/16/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of the present study was to analyze whether or not parity influenced the prevalence of obesity in both pre- and postmenopausal women. SUBJECTS AND METHODS A cross-sectional study was conducted on characteristics of urban women regarding parity. A total of 1,620 women aged 45-63 years were selected using cluster sampling. A face-to-face household interview was conducted by trained, skillful personnel. A risk factor questionnaire was used to obtain information on reproductive history and sociodemographic factors. Statistical associations between parity and obesity using logistic regression were then investigated. RESULTS The mean BMI was 29.1 ± 5.1, and 96.8% of the sample population were parous, with a median of 4 births. Of the total women enrolled, 216 (13.3%) had <3 parities, while 1,404 (86.7%) had ≥3 parities. The prevalence of obesity (BMI ≥30) was 38.3%, diagnosed at a mean age of 51.4 ± 5.2 years. After adjustment for a range of potential confounders (age, marital status, employment, education, smoking status, abortion history, savings situation and menopausal status), women with ≥3 parities were at higher risk of being obese (OR 1.74, 95% CI 1.24-2.45; p = 0.001). CONCLUSION A positive association was observed between the number of parities and obesity. The findings of this study suggest that the BMI is associated with high parity in Babolian women. Health policymakers should work with health providers to develop appropriate postpartum weight loss interventions.
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Affiliation(s)
- Mahmoud Hajiahmadi
- Department of Social Medicine and Health, Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Hamid Shafi
- Department of Surgery, Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Mouloud Agajani Delavar
- Department of Midwifery, Fatemezahra Infertility and Reproductive Health Research Center, Babol University of Medical Sciences, Babol, Iran
- *Mouloud Agajani Delavar, Department of Midwifery, Babol University of Medical Sciences, Babol 4717647745 (Iran), E-Mail
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Kim JH, Jung Y, Kim SY, Bae HY. Impact of age at first childbirth on glucose tolerance status in postmenopausal women: the 2008-2011 Korean National Health and Nutrition Examination Survey. Diabetes Care 2014; 37:671-7. [PMID: 24241788 DOI: 10.2337/dc13-1784] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of the current study was to determine whether there was an association between age at first childbirth and glucose tolerance status in postmenopausal women. RESEARCH DESIGN AND METHODS This study was based on the data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008-2011. Of 37,753 participants, data for 4,965 postmenopausal women were included in the analysis. Subjects were subdivided according to the age at first childbirth as follows: ≤19, 20-24, 25-29, and ≥30 years. Multivariate logistic regression analyses were used to identify whether there was an independent association between age at first childbirth and glucose tolerance status by adjusting for potential confounding factors. RESULTS The prevalence of impaired fasting glucose (IFG) and diabetes was 21.8% (1.066 of 4.965) and 15.3% (774 of 4,965), respectively. Diabetes prevalence differed significantly between the subgroups and was higher with earlier age at first childbirth: it was 10.9% in subjects aged ≥30 years and 23.8% in subjects aged ≤19 years at first childbirth. After fully adjusting for potential confounding factors, including lifestyle, sociodemographic factors, known diabetes risk factors, and reproductive factors, age at first childbirth ≤19 years was significantly associated with diabetes (odds ratio 1.492 [95% CI 1.005-2.215]). No significant associations were found between age at first childbirth and IFG. CONCLUSIONS Age at first childbirth influenced diabetes risk in postmenopausal women, and adolescent pregnancy was independently associated with a higher risk of diabetes in postmenopausal women.
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Abstract
OBJECTIVES Studies regarding the effects of parity on blood pressure in later life produced conflicting results. The aim of our study is to analyse whether parity influences the prevalence of hypertension in perimenopausal and postmenopausal women. METHODS One thousand perimenopausal and postmenopausal women (mean age 55.2 ± 5.4 years) were enrolled with a median follow-up of 63.0 months. The study sample consisted of patients who self-referred, in 1998-2009, to the BenEssere Donna Clinic, dedicated to menopause-related disorders. RESULTS One hundred and twenty-two (12.2%) women were nulliparous and 878 (87.8%) had at least one child. Thirty-four (27.9%) women among nulliparous and 326 (37.1%) among parous were hypertensive at baseline (P = 0.046) and 812 women (81.2%) were in their postmenopausal period. Univariate analysis showed that women with one or more children were at higher risk of being hypertensive [odds ratio (OR): 1.529; 95% confidence interval (CI): 1.006-2.324; P = 0.047]. Likewise, multivariate analysis revealed that parity (OR: 2.907; 95% CI: 1.290-6.547; P = 0.010), BMI (OR: 1.097; 95% CI: 1.048-1.149; P < 0.001) and family history of hypertension (OR: 3.623; 95% CI: 2.231-5.883; P < 0.001) were independently related to hypertension at baseline. In a subanalysis of 640 initially normotensive women, 109 (17.0%) patients developed hypertension after follow-up, without a statistically significant association with parity (13.6% in nulliparous versus 17.6% in parous; P = 0.362). Consistently, parity showed no relationship with the incidence of hypertension during follow-up (OR: 1.350; 95% CI: 0.707-2.579; P = 0.363). CONCLUSION For the first time in a population of White perimenopausal and postmenopausal women, parity was demonstrated to be independently associated with early hypertension during menopausal transition. Conversely, postmenopausal hypertension was not related with parity.
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Akter S, Jesmin S, Rahman MM, Islam MM, Khatun MT, Yamaguchi N, Akashi H, Mizutani T. Higher gravidity and parity are associated with increased prevalence of metabolic syndrome among rural Bangladeshi women. PLoS One 2013; 8:e68319. [PMID: 23936302 PMCID: PMC3732242 DOI: 10.1371/journal.pone.0068319] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 05/28/2013] [Indexed: 01/04/2023] Open
Abstract
Background Parity increases the risk for coronary heart disease; however, its association with metabolic syndrome among women in low-income countries is still unknown. Objective This study investigates the association between parity or gravidity and metabolic syndrome in rural Bangladeshi women. Methods A cross-sectional study was conducted in 1,219 women aged 15–75 years from rural Bangladesh. Metabolic syndrome was defined according to the standard NCEP-ATP III criteria. Logistic regression was used to estimate the association between parity and gravidity and metabolic syndrome, with adjustment of potential confounding variables. Results Subjects with the highest gravidity (> = 4) had 1.66 times higher odds of having metabolic syndrome compared to those in the lowest gravidity (0-1) (Ptrend = 0.02). A similar association was found between parity and metabolic syndrome (Ptrend = 0.04), i.e., subjects in the highest parity (> = 4) had 1.65 times higher odds of having metabolic syndrome compared to those in the lowest parity (0-1). This positive association of parity and gravidity with metabolic syndrome was confined to pre-menopausal women (Ptrend <0.01). Among the components of metabolic syndrome only high blood pressure showed positive association with parity and gravidity (Ptrend = 0.01 and <0.001). Neither Parity nor gravidity was appreciably associated with other components of metabolic syndrome. Conclusions Multi parity or gravidity may be a risk factor for metabolic syndrome.
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Affiliation(s)
- Shamima Akter
- Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, Probal Housing Ltd., Mohammadpur, Dhaka, Bangladesh
- National Center for Global Health and Medicine (NCGM), Toyama, Shinjuku-ku, Tokyo, Japan
| | - Subrina Jesmin
- Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, Probal Housing Ltd., Mohammadpur, Dhaka, Bangladesh
- 2 Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- * E-mail:
| | - Md. Mizanur Rahman
- Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, Probal Housing Ltd., Mohammadpur, Dhaka, Bangladesh
- Department of Global Health Policy, University of Tokyo, Tokyo, Japan
| | - Md. Majedul Islam
- Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, Probal Housing Ltd., Mohammadpur, Dhaka, Bangladesh
| | - Most. Tanzila Khatun
- Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, Probal Housing Ltd., Mohammadpur, Dhaka, Bangladesh
| | - Naoto Yamaguchi
- Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, Probal Housing Ltd., Mohammadpur, Dhaka, Bangladesh
| | - Hidechika Akashi
- National Center for Global Health and Medicine (NCGM), Toyama, Shinjuku-ku, Tokyo, Japan
| | - Taro Mizutani
- 2 Graduate School of Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Winkvist A, Bertz F, Ellegård L, Bosaeus I, Brekke HK. Metabolic risk profile among overweight and obese lactating women in Sweden. PLoS One 2013; 8:e63629. [PMID: 23667649 PMCID: PMC3646790 DOI: 10.1371/journal.pone.0063629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/01/2013] [Indexed: 11/20/2022] Open
Abstract
Background Obesity and cardiovascular diseases are increasing globally and any association between reproduction and these conditions is of concern. Unfortunately, little is known about normal levels of metabolic risk factors in women of different body mass index throughout the reproductive cycle. This study is one of the first to describe the metabolic risk profile of lactating overweight or obese women at 8–12 weeks postpartum. Methods During 2007–2009, 66 overweight or obese Swedish lactating women without known diseases underwent detailed measurements of their metabolic profiles, dietary intake and general health before entering a lifestyle intervention trial. Baseline measurements took place between 8–12 wk postpartum. Almost all women were exclusively breastfeeding their term infants. Results The women were regarded as healthy, as reflected in the absence of diagnosed diseases, their own perceptions and in normal hemoglobin, albumin and fasting plasma glucose values. Four women were diagnosed with metabolic syndrome. In these cases, underlying conditions included large waist circumference, low HDL cholesterol values, high triglyceride values and relatively high blood pressure. The metabolic profile differed between overweight and obese women; obese women had significantly higher levels of fasting insulin (p = 0.017), borderline higher HOMA values (p = 0.057) and significantly higher triglyceride values (p = 0.029), as well as larger waist and hip circumferences (p<0.001 and p<0.001). However, no significant differences between overweight and obese women were detected for LDL or total cholesterol levels. Overweight and obese women reported similar total energy and macronutrient intakes, but obese women tended to be less physically active (p = 0.081). Conclusions Among generally healthy lactating women, obesity as compared to overweight is associated with increased metabolic risk. This cut-off is thus important also in the early postpartum period, and obesity among these women should warrant proper health investigation. Macronutrient intake did not differ between the groups and, hence, cannot explain these differences. Trial registration ClinicalTrials.gov Identifier: NCT01343238
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Affiliation(s)
- Anna Winkvist
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Rodrigues AD, Theodoro H, Mendes KG, Paniz VM, de Lorenzi D, Anselmo Olinto MT. Factors associated with metabolic syndrome in climacteric women of southern Brazil. Climacteric 2012; 16:96-103. [DOI: 10.3109/13697137.2012.659099] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- A. D. Rodrigues
- University of Vale do Rio dos Sinos, Post-Graduate Program of Collective Health, São Leopoldo
| | - H. Theodoro
- University of Vale do Rio dos Sinos, Post-Graduate Program of Collective Health, São Leopoldo
| | | | - V. M. Paniz
- University of Vale do Rio dos Sinos, Post-Graduate Program of Collective Health, São Leopoldo
| | | | - M. T. Anselmo Olinto
- University of Vale do Rio dos Sinos, Post-Graduate Program of Collective Health, São Leopoldo
- Federal University of Health Science of Porto Alegre, Nutrition, Porto Alegre, Brazil
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Abstract
Parity is associated with weight retention and has long-lasting and detrimental effects on the health of women. Previous studies have shown that increasing parity was independently associated with an increased prevalence of metabolic syndrome. Postpartum weight is made up of several components including uterine and mammary tissues, body water (intracellular (ICW) and extracellular water (ECW)), and fat. These components change in variable amounts postpartum, thereby distinctly affecting the interpretation of individual weight retention; however, it is unclear which components contribute to weight retention. The aims of this longitudinal study were to evaluate changes in body composition during the postpartum period and to investigate their effects on weight retention. This prospective study examined 41 healthy, pregnant women who gave birth at Korea University Guro Hospital. We measured body composition at 2 days, 2 weeks, and 6 weeks postpartum using bioelectrical impedance analysis. Weight decreased during this postpartum period (P < 0.001); the postpartum weight retention from prepregnancy to 6 weeks postpartum was 4.43 ± 4.0 kg. Among various body composition components, ECW, ICW, total body water, and fat-free mass (FFM) decreased postpartum. However, fat mass (FM) and visceral fat area, the components that experienced the greatest changes, increased postpartum. Our results demonstrate that the postpartum period is associated with a preferential accumulation of adipose tissue in the visceral compartment, even though overall body weight is decreased. Further studies are needed to evaluate the changes in body composition over longer time periods and their long-term effects on health.
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Affiliation(s)
- Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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