Higher parity and risk of metabolic syndrome in Korean postmenopausal women: Korea National Health and Nutrition Examination Survey 2010-2012

Metabolic syndrome clustering patterns and the association with cardiovascular disease among post-menopausal Korean women

The metabolic syndrome (MetS) is a group of diseases conceptualized as a clustering of risk factors, with the risks of developing MetS in women varying significantly before and after menopause. This study investigated MetS clustering patterns and their association with cardiovascular disease (CVD) risk among post-menopausal women (n = 2479) using data from the Korean Genome Epidemiology Study. Using latent class analysis, three groups emerged: diabetic (5.6%), hypertensive (35.2%), and low-risk (59.2%). Relative to the low-risk group, the diabetic group demonstrated associations with older age, a family history of chronic disease, an increased Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), an elevated white blood cell (WBC) count, experience with hysterectomy, being a non-drinker, more physical activity, and excessive sleep. The hypertensive group was associated with older age, lower monthly income, a family history of chronic disease, increased HOMA-IR, a higher WBC count, more physical activity, and excessive sleep. The diabetic and hypertensive groups had a significantly higher CVD risk than the low-risk group (diabetic: odds ratio [OR] = 2.41 [1.11, 5.27]; hypertensive: OR = 2.46 [1.33, 4.55]). This study identified potential markers for MetS screening in post-menopausal women, highlighting the need for early intervention and personalized healthcare for middle-aged women to reduce CVD risk following menopause.

The association of female reproductive factors with risk of metabolic syndrome in women from NHANES 1999-2018

BACKGROUND

Female reproductive factors such as age at first birth (AFB), age at last birth (ALB), number of pregnancies and live births play an essential role in women's health. However, few epidemiological studies have evaluated the association between female reproductive factors and metabolic syndrome (MetS). We therefore conducted a cross-sectional study to investigate the association between MetS risk and female reproductive factors.

METHODS

We investigated the relationship between AFB, ALB, number of pregnancies and live births and the incidence of MetS using publicly available data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Weighted multivariable logistic regression analysis, restricted cubic spline (RCS) model, and subgroup analysis were used to evaluate the association between AFB and ALB and the risk of MetS in women. In addition, the relationship between the number of pregnancies, live births and MetS risk was also explored.

RESULTS

A total of 15,404 women were included in the study, and 5,983 (38.8%) had MetS. RCS models showed an N-shaped relationship between AFB and MetS risk, whereas ALB, number of pregnancies, and live births were linearly associated with MetS. Weighted multivariable logistic regression analysis showed that the number of live births was associated with MetS risk, with ORs of 1.18 (95% CI: 1.04, 1.35) for women with ≥ 5 deliveries compared to women with ≤ 2 births.

CONCLUSIONS

AFB was associated with the risk of MetS in an N-shaped curve in women. In addition, women with high live births have a higher incidence of MetS.

Reproductive factors and metabolic syndrome among Chinese women aged 40 years and older

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.

Parity and Metabolic Syndrome Risk: A Systematic Review and Meta-Analysis of 15 Observational Studies With 62,095 Women

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].

Correlation between parity and metabolic syndrome in Chinese women aged 40 years and older: the Reaction study

AIMS

The purpose of the present study was to investigate the correlation between the number of live-birth pregnancies and metabolic syndrome (MetS) in Chinese women according to menstruation history.

METHODS

Registry data for all pregnancies in a cohort of 6157 Chinese women aged 40 years or older were obtained and the number of live-birth pregnancies were enumerated. We defined MetS using five criteria: impaired insulin metabolism and glucose tolerance, obesity in the abdominal area, dyslipidemia, and hypertension. Multivariate logistic regression analysis was conducted to assess potential risk factors for MetS. Postmenopausal women with three or more of live-birth pregnancies had the highest prevalence of MetS (P < 0.05).

RESULTS

Among the 6157 females aged 40 years or older in Luzhou city, 2143 (34.8%) participants had incident MetS. The number of live-birth pregnancies was significantly correlated with age and fasting blood glucose (FBG) level (P < 0.05). The prevalence of MetS increased with the number of live-birth pregnancies (P < 0.01), and the frequency in postmenopausal women was significantly higher than that in premenopausal women (P < 0.001). In the binary logistic regression model, menopausal status [OR = 0.343 (0.153-0.769), P < 0.001] were significantly associated with an increased risk of MetS.

CONCLUSIONS

The number of live-birth pregnancies is correlated with an increased risk of MetS in Chinese women aged 40 years and over, especially in postmenopausal women. Greater attention should be paid to postmenopausal women who have had multiple live-birth pregnancies with a view to intervening early to prevent related diseases.

The association between parity and metabolic syndrome and its components in normal-weight postmenopausal women in China

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.

Comparison of health-related habits and metabolic syndrome risk factors according to obesity type in Korean postmenopausal women

OBJECTIVE

This study aimed to investigate the differences in health-related habits, metabolic syndrome risk factors, and related diseases prevalence according to obesity type in postmenopausal women.

METHODS

This cross-sectional study used a data set of 1,443 postmenopausal women who were 40 years or older (range = 45-80, mean = 64.10) from the 2016 Korean National Health and Nutrition Examination Survey VII-1. The participants were classified into normal group (body mass index [BMI] <25 kg/m, waist circumference (WC) <85 cm), BMI obesity group (BMI ≥25 kg/m, WC <85 cm), abdominal obesity group (BMI <25 kg/m, WC ≥85 cm), and BMI and abdominal obesity group (BMI ≥25 kg/m, WC ≥85 cm). To compare health-related habits and metabolic syndrome risk factors according to obesity type, a chi-square test and t test were performed. The relationship between obesity and metabolic syndrome was assessed using a logistic regression analysis of adjusted demographic and women's health covariates.

RESULTS

The abdominal obesity group had a significantly longer sedentary time per day (524.31 min), a higher activity restriction rate (25.0%), and a lower nutrition labeling recognition rate (3.6%) than the other groups (P < 0.001). The occurrence of metabolic syndrome was the highest in the BMI and abdominal obesity group (66.1%), followed by the abdominal obesity group (59.3%). Compared with the normal group, the prevalence of metabolic syndrome was significantly higher in the BMI obesity group (adjusted odds ratio [OR] = 2.23, 95% CI = 1.15-4.31), abdominal obesity group (adjusted OR = 7.33, 95% CI = 4.38-12.25), and the BMI and abdominal obesity group (adjusted OR = 12.44, 95% CI = 8.78-17.62).

CONCLUSIONS

In postmenopausal women, the abdominal obesity group was associated with a high prevalence of metabolic syndrome and related diseases. Therefore, to reduce abdominal obesity in postmenopausal women, it is necessary to correct long sedentary time, high activity restriction rate, and low nutritional labeling recognition rate identified as health-related habits of the abdominal obesity group.

Metabolic syndrome in pregnancy and postpartum: prevalence and associated factors

OBJECTIVE

Evaluate the prevalence of metabolic syndrome (MS) and the main associated maternal factors in women without pre-gestational conditions, in early pregnancy and in the immediate postpartum.

METHODS

Two hundred pregnant women were evaluated at the 16th week of pregnancy, and 187 were reassessed postpartum. MS was diagnosed according to the criteria by the National Cholesterol Education Program Adult Treatment Panel III. In addition to the diagnostic criteria, anthropometric measures, blood pressure, metabolic profile, and visceral and subcutaneous fat thickness (by ultrasonography) were collected from the pregnant woman. The student's t-test was used to compare the prevalence of MS and its components in the 16th week and in the postpartum. Multiple logistic regression was performed to identify the principal factors associated with the syndrome.

RESULTS

The prevalence of the MS was 3.0% in early pregnancy and 9.7% postpartum (p=0.01). Following multiple logistic regression, the prepregnancy body mass index (BMI) (p=0.04) and high-density lipoprotein cholesterol (HDL-c) (p=0.02) remained associated with MS at 16 weeks, and triglyceride levels evaluated in postpartum (p<0.001) with MS in postpartum.

CONCLUSION

The frequency of the MS was high in the immediate postpartum. The factors associated were prepregnancy BMI and HDL-c at the 16th week, as well as triglyceride levels postpartum.

Duration of reproductive years and time since menopause were associated with metabolic syndrome in postmenopausal parous women of Chinese ancestry

OBJECTIVE

Although duration of reproductive years and time since menopause were previously implicated in the metabolic syndrome, the evidence is more limited. Few of the previous studies were able to take into account related reproductive variables simultaneously. The aim of the present study was to explore the influence of these two reproductive factors on the prevalence of metabolic syndrome in postmenopausal parous women from Southeast China.

METHODS

In all, 1,536 postmenopausal parous women were recruited. Self-reported information about reproductive status, including age at menarche, age at menopause, number of children, prepregnancy body weight, and oral contraceptive use, was collected, and duration of reproductive years and time since menopause were calculated. Clinical parameters related with metabolic syndrome were also measured.

RESULTS

Longer duration of reproductive years was significantly related with increased presence of the metabolic syndrome (odds ratio [OR] 1.570, 95% confidence interval [CI] 1.091, 2.259 for tertile 2 group; OR 1.850, 95% CI 1.163, 2.944 for tertile 3 group; P for trend = 0.010). Women with more than 20 years since menopause were more likely to experience metabolic syndrome (OR 2.422, 95% CI 1.109, 5.286, P = 0.026) and elevated blood pressure (OR 3.239, 95% CI 1.406, 7.458, P = 0.006) when compared with those with less than 10 years since menopause.

CONCLUSIONS

Longer duration of reproductive years and time since menopause were associated with higher prevalence of metabolic syndrome in postmenopausal parous women from Southeast China.