Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease.
Menstrual Cycle Regularity and Length Across the Reproductive Lifespan and Risk of Cardiovascular Disease.
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DOI：
10.1001/jamanetworkopen.2022.38513
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发表时间：
2022-10-03
影响因子：
13.8
通讯作者：
Chavarro, Jorge E.
中科院分区：
文献类型：
--
作者：
Wang, Yi-Xin;Stuart, Jennifer J.;Rich-Edwards, Janet W.;Missmer, Stacey A.;Rexrode, Kathryn M.;Farland, Leslie, V;Mukamal, Kenneth J.;Nelson, Scott M.;Solomon, Caren G.;Fraser, Abigail;Chavarro, Jorge E.
生殖生命周期中的月经周期特征是否与心血管疾病（CVD）的风险相关，这些相关性在多大程度上由高胆固醇血症、慢性高血压和糖尿病介导？在这项对80630名女性进行的队列研究中，在整个生殖生命周期中，不规则和长月经周期与CVD风险增加相关，独立于已确定的心血管疾病风险因素。中介分析表明，只有一小部分的关联是由高胆固醇血症，慢性高血压和2型糖尿病解释的。这些结果表明，在整个生殖生命周期的月经周期的特点，可作为额外的标志物的心血管疾病的风险在妇女。这项针对美国护士的队列研究考察了生殖寿命期间月经周期不规则和过长与心血管疾病风险的关系。月经周期特征可能与心血管疾病（CVD）风险增加有关。然而，现有的研究是有限的，很少有人探讨了已建立的CVD危险因素的介导作用。探讨整个生殖生命周期的月经周期特征与CVD风险的相关性，以及这些相关性在多大程度上由高胆固醇血症、慢性高血压和2型糖尿病介导。这项队列研究前瞻性地随访了1993年至2017年期间的护士健康研究II参与者，他们在1989年入组时报告了14至17岁和18至22岁的月经周期规律性和长度，并在1993年更新了当前的周期特征（29至46岁）。数据分析于2019年10月1日至2022年1月1日进行。月经周期的规律性和整个生殖寿命的长度。关注的新发CVD事件，包括致死性和非致死性冠心病（CHD;心肌梗死[MI]或冠状动脉血运重建）和卒中。共有80630名护士健康研究II参与者被纳入分析，基线时平均（SD）年龄为37.7（4.6）岁，体重指数为25.1（5.6）。在24年的前瞻性随访中，1816名女性发生了首次CVD事件。多变量考克斯比例风险模型显示，与在相同年龄报告月经周期非常规律的女性相比，在14至17岁、18至22岁或29至46岁时月经周期不规律或没有月经周期的女性发生CVD的风险比为1.15（95% CI，0.99-1.34）、1.36（95% CI，1.06-1.75）和1.40（95% CI，1.14-1.71）。同样，与报告周期长度为26至31天的女性相比，报告周期长度为40天或更长或周期太不规则而无法估计18至22岁或29至46岁的女性CVD的风险比分别为1.44（95%CI，1.13-1.84）和1.30（95%CI，1.09-1.57）。中介分析表明，随后发生的高血压、慢性高血压和2型糖尿病仅解释了观察到的相关性的5.4%至13.5%。在这项队列研究中，不规则和长月经周期都与CVD发病率增加相关，即使在考虑了随后确定的CVD风险因素后，CVD发病率也持续增加。
Are menstrual cycle characteristics across the reproductive lifespan associated with the risk of cardiovascular disease (CVD), and to what extent are these associations mediated by hypercholesterolemia, chronic hypertension, and diabetes? In this cohort study of 80 630 women, irregular and long menstrual cycles across the reproductive lifespan were associated with an increased risk of CVD, independent of established cardiovascular disease risk factors. Mediation analysis showed that only a small proportion of the associations were explained by hypercholesterolemia, chronic hypertension, and type 2 diabetes. These results suggest that menstrual cycle characteristics throughout the reproductive lifespan may be used as additional markers of CVD risk in women. This cohort study of US nurses examines the association of irregular and long menstrual cycles across the reproductive lifespan with risk of cardiovascular disease. Menstrual cycle characteristics may be associated with an increased risk of cardiovascular disease (CVD). However, existing studies are limited, and few have explored the mediating role of established CVD risk factors. To explore the associations of menstrual cycle characteristics across the reproductive lifespan with the risk of CVD and to what extent these associations were mediated by hypercholesterolemia, chronic hypertension, and type 2 diabetes. This cohort study prospectively followed Nurses’ Health Study II participants between 1993 and 2017 who reported menstrual cycle regularity and length for ages 14 to 17 years and 18 to 22 years at enrollment in 1989 and updated current cycle characteristics in 1993 (at ages 29 to 46 years). Data analysis was performed from October 1, 2019, to January 1, 2022. Menstrual cycle regularity and length across the reproductive lifespan. Incident CVD events of interest, including fatal and nonfatal coronary heart disease (CHD; myocardial infarction [MI] or coronary revascularization) and stroke. A total of 80 630 Nurses’ Health Study II participants were included in the analysis, with a mean (SD) age of 37.7 (4.6) years and body mass index of 25.1 (5.6) at baseline. Over 24 years of prospective follow-up, 1816 women developed their first CVD event. Multivariable Cox proportional hazards models showed that, compared with women reporting very regular cycles at the same ages, women who had irregular cycles or no periods at ages 14 to 17, 18 to 22, or 29 to 46 years had hazard ratios for CVD of 1.15 (95% CI, 0.99-1.34), 1.36 (95% CI, 1.06-1.75), and 1.40 (95% CI, 1.14-1.71), respectively. Similarly, compared with women reporting a cycle length of 26 to 31 days, women reporting a cycle length 40 days or more or a cycle too irregular to estimate from ages 18 to 22 or 29 to 46 years had hazard ratios for CVD of 1.44 (95% CI, 1.13-1.84) and 1.30 (95% CI, 1.09-1.57), respectively. Mediation analyses showed that subsequent development of hypercholesteremia, chronic hypertension, and type 2 diabetes only explained 5.4% to 13.5% of the observed associations. In this cohort study, both irregular and long menstrual cycles were associated with increased rates of CVD, which persisted even after accounting for subsequently established CVD risk factors.
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子宫内膜异位和高胆固醇血症或高血压之间的关联。
DOI：
10.1161/hypertensionaha.117.09056
发表时间：
2017-07
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Mu F;Rich-Edwards J;Rimm EB;Spiegelman D;Forman JP;Missmer SA
通讯作者：
Missmer SA
DOI：
10.1136/bmj.n530
发表时间：
2021-03-24
期刊：
BMJ (Clinical research ed.)
影响因子：
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作者：
Wang YX;Mínguez-Alarcón L;Gaskins AJ;Missmer SA;Rich-Edwards JW;Manson JE;Pan A;Chavarro JE
通讯作者：
Chavarro JE
影响因子：
168.9
作者：
RIMM, EB;GIOVANNUCCI, EL;STAMPFER, MJ
通讯作者：
STAMPFER, MJ
DOI：
10.1111/1471-0528.16692
发表时间：
2021-04-06
影响因子：
5.8
作者：
Okoth, K.;Wang, J.;Adderley, N. J.
通讯作者：
Adderley, N. J.
影响因子：
5
作者：
Jukic, Anne Marie Zaura;Weinberg, Clarice R.;Baird, Donna D.
通讯作者：
Baird, Donna D.