Parity, postmenopausal estrogen use, and cardiovascular disease risk factors in American Indian women: The Strong Heart Study
Parity, postmenopausal estrogen use, and cardiovascular disease risk factors in American Indian women: The Strong Heart Study
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DOI：
10.1089/jwh.1997.6.441
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发表时间：
1997-08-01
影响因子：
3.5
通讯作者：
Welty, TK
中科院分区：
文献类型：
--
作者：
Cowan, LD;Go, OT;Welty, TK
研究表明，高产次与心血管疾病（CVD）风险增加有关。风险增加的原因尚不清楚，但可能包括生育对CVD风险因素水平的影响。本研究探讨了美国印第安妇女的奇偶校验和心血管疾病的危险因素，其中大家庭是常见的协会。还评估了雌激素使用和CVD风险因素。这项研究包括1982名年龄在45岁至74岁之间的已婚绝经后妇女，她们参加了强心研究（SHS），这是一项针对美国三个地理区域的美洲印第安人的大型研究。在体格检查和面谈期间获得信息。胎次范围为0 - 18（中位数5）。目前雌激素的使用从亚利桑那州的5%到俄克拉荷马州的21%不等。多变量分析发现，产次与高密度脂蛋白（HDL）胆固醇之间存在统计学显著的负相关，尽管随着产次的增加，差异很小（每增加一个活产，差异为-0.26 mg/dl）。雌激素使用者的低密度脂蛋白胆固醇（-6.4 mg/dl）和纤维蛋白原（-26.2 mg/dl）水平显著较低，腰/臀比（-0.02）较低，HDL（5 mg/dl）和对数（In）甘油三酯（0.13 mg/dl）值较高。目前使用者患高血压的可能性略高（患病率比值比，1.56）。产次和心血管疾病的危险因素之间的关系，在美国印第安妇女与高产次建议只有很小的差异，增加产次。与雌激素使用的关联要强得多，与其他女性群体中观察到的相似。
Studies have suggested that high parity is related to an increased risk of cardiovascular disease (CVD). Reasons for an increased risk are unclear but may include influences of child-bearing on levels of CVD risk factors. The present study examined the associations of parity and CVD risk factors in American Indian women, among whom large families are common. Estrogen use and CVD risk factors also were assessed. The study included 1982 ever-married, postmenopausal women aged 45 through 74 years who participated in the Strong Heart Study (SHS), a large study of American Indians in three geographic areas of the United States. Information was obtained during a physical examination and interview. Parity ranged from 0 to 18 (median 5). Current estrogen use varied from 5% in Arizona to 21% in Oklahoma. Multivariable analyses found a statistically significant, inverse association between parity and high-density lipoprotein (HDL) cholesterol, although the difference with increasing parity was small (-0.26 mg/dl per additional live birth). Estrogen users had significantly lower levels of low-density lipoprotein cholesterol (-6.4 mg/dl) and fibrinogen (-26.2 mg/dl) and a lower waist/hip ratio (-0.02), and higher values of HDL (5 mg/dl) and logarithm (In) triglyceride (0.13 mg/dl). Current users were slightly more likely to be hypertensive (prevalence odds ratio, 1.56). Relations between parity and CVD risk factors in American Indian women with high parity suggested only small differences with increasing parity. Associations with estrogen use are much stronger and are similar to those observed in other groups of women.