Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-Year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults).
Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-Year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults).
复制标题
作者：
Gunderson EP;Jacobs DR Jr;Chiang V;Lewis CE;Feng J;Quesenberry CP Jr;Sidney S
本研究的目的是前瞻性地评估哺乳期与育龄妇女代谢综合征发病率之间的关系。参加者为1，399名妇女（39%黑人，年龄18-30岁）在年轻成人冠状动脉风险发展（CARDIA）研究中，这是一项正在美国进行的多中心、基于人群的前瞻性观察性队列研究。（1985-1986）和随后的怀孕前，并在基线后7年，10年，15年和/或20年复查。根据国家胆固醇教育计划成人治疗小组III（NCEP ATP III）标准确定代谢综合征病例参与者。互补双对数模型估计了根据年龄、种族、研究中心、基线协变量（BMI、代谢综合征组分、教育、吸烟、体力活动）和时间依赖性产次调整的妊娠期糖尿病（GDM）的时间依赖性哺乳期类别中代谢综合征事件的相对危险度。在704例经产妇女（620例非GDM，84例GDM）中，在9，993人-年中有120例代谢综合征病例参与者（总发病率为12.0/1，000人-年;非GDM为10.8，GDM为22.1）。从0-1个月到>9个月，哺乳期延长与较低的粗代谢综合征发病率相关（P < 0.001）。完全校正的相对危险度显示，GDM组（相对危险度范围0.14-0.56; P = 0.03）与非GDM组（相对危险度范围0.44-0.61; P = 0.03）相比，与哺乳期延长相关的风险降低更强。在控制了孕前测量、BMI、社会人口统计学和生活方式特征后，有GDM史和无GDM史的女性中，较长的哺乳期与断奶后数年代谢综合征的发病率较低相关。哺乳可能对女性的心脏代谢健康有持续的有利影响。
The objective of the study was to prospectively assess the association between lactation duration and incidence of the metabolic syndrome among women of reproductive age. Participants were 1,399 women (39% black, aged 18–30 years) in the Coronary Artery Risk Development in Young Adults (CARDIA) Study, an ongoing multicenter, population-based, prospective observational cohort study conducted in the U.S. Women were nulliparous and free of the metabolic syndrome at baseline (1985–1986) and before subsequent pregnancies, and reexamined 7, 10, 15, and/or 20 years after baseline. Incident metabolic syndrome case participants were identified according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Complementary log-log models estimated relative hazards of incident metabolic syndrome among time-dependent lactation duration categories by gestational diabetes mellitus (GDM) adjusted for age, race, study center, baseline covariates (BMI, metabolic syndrome components, education, smoking, physical activity), and time-dependent parity. Among 704 parous women (620 non-GDM, 84 GDM), there were 120 incident metabolic syndrome case participants in 9,993 person-years (overall incidence rate 12.0 per 1,000 person-years; 10.8 for non-GDM, 22.1 for GDM). Increased lactation duration was associated with lower crude metabolic syndrome incidence rates from 0–1 month through >9 months (P < 0.001). Fully adjusted relative hazards showed that risk reductions associated with longer lactation were stronger among GDM (relative hazard range 0.14–0.56; P = 0.03) than non-GDM groups (relative hazard range 0.44–0.61; P = 0.03). Longer duration of lactation was associated with lower incidence of the metabolic syndrome years after weaning among women with a history of GDM and without GDM, controlling for preconception measurements, BMI, and sociodemographic and lifestyle traits. Lactation may have persistent favorable effects on women's cardiometabolic health.
登录
查看更多内容
DOI：
10.1016/0197-2456(91)90002-4
发表时间：
1991-02-01
期刊：
Controlled clinical trials
影响因子：
--
作者：
Cutter, G R;Burke, G L;Manolio, T A
通讯作者：
Manolio, T A
影响因子：
4.2
作者：
Butte, NF;Hopkinson, JM
通讯作者：
Hopkinson, JM
影响因子：
7.1
作者：
BREWER, MM;BATES, MR;VANNOY, LP
通讯作者：
VANNOY, LP
影响因子：
9.8
作者：
Gunderson, Erica P.;Jacobs, David R., Jr.;Sidney, Stephen
通讯作者：
Sidney, Stephen
影响因子：
7.7
作者：
Gunderson, Erica P.;Lewis, Cora E.;Sidney, Stephen
通讯作者：
Sidney, Stephen