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目的:探讨生育因素与绝经后妇女代谢综合征患病风险之间的关系。方法:716名绝经后妇女纳入本研究,通过问卷调查采集其生育因素,同时检测生化指标。代谢综合征定义采用按照亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第3次报告(NCEP-ATPⅢ)诊断标准。采用多元逐步回归和多因素Logistic回归分析生育因素与代谢综合征及其组分之间的关系。结果:本研究人群代谢综合征患病率为43.85%。患有代谢综合征的绝经后妇女初潮年龄明显小于无代谢综合征组(P=0.001 1)。多元Logistic回归结果显示,随着初潮年龄的增加,代谢综合征的患病风险下降[比值比(OR)=0.858;95%可信区间(CI):0.752~0.980]。而其他生育因素,包括绝经年龄、停经年限、怀孕次数、是否哺乳、哺乳时间、口服避孕药或激素替代治疗等则与代谢综合征的患病风险无关。结论:在各种生育因素中,初潮年龄小提示绝经后妇女代谢综合征的患病风险高。
Objective: To investigate the relationship between fertility and the prevalence of metabolic syndrome in postmenopausal women. Methods: A total of 716 postmenopausal women were enrolled in this study. Their fertility factors were collected through questionnaire survey, and biochemical indexes were also tested. Metabolic syndrome was defined using the NCEP-ATP III diagnostic criteria of the American National Cholesterol Education Program, an improved third-generation report based on Asian characteristics. Multivariate stepwise regression and multivariate Logistic regression analysis of fertility factors and metabolic syndrome and its relationship between components. Results: The prevalence of metabolic syndrome in this study population was 43.85%. Menopausal women with metabolic syndrome had significantly shorter menarche age than those without metabolic syndrome (P = 0.001 1). Multivariate logistic regression showed that the risk of metabolic syndrome decreased with increasing menarche age [odds ratio (OR) = 0.858; 95% confidence interval (CI): 0.752 to 0.980]. Other fertility factors, including age at menopause, menopause, number of pregnancies, breast-feeding, breast-feeding time, oral contraceptives or hormone replacement therapy, are not associated with the prevalence of metabolic syndrome. CONCLUSIONS: Among all fertility factors, younger age of menarche suggests a higher prevalence of metabolic syndrome in postmenopausal women.