目的:女性的生殖因素与中年和晚年的身体虚弱和综合虚弱有关吗?
结论:初潮早13岁,绝经年龄<45岁,手术更年期,经历流产和<35年的较短生育期与虚弱的几率增加有关,而有两个或三个孩子与虚弱的可能性降低有关。
背景:有证据表明,在所有年龄段和不同人群中,女性都比男性更脆弱,虽然女性的寿命更长.女性特有的生殖因素可能与女性虚弱的风险有关。
■一项基于人群的横断面研究涉及来自英国生物银行的189.898名女性。
方法:使用虚弱表型和虚弱指数评估身体虚弱和综合虚弱(使用38项身心健康指标进行评估),分别。使用多变量逻辑回归模型来估计生殖因素与身体虚弱和综合虚弱的可能性之间的比值比(ORs)和95%CI。使用受限制的三次样条模型来测试它们之间的非线性关联。此外,我们研究了绝经期分类年龄和绝经期激素治疗(MHT)对虚弱的综合影响.
结果:初潮年龄之间存在J形关系,生育期,虚弱;初潮年龄<13岁和>16岁,和生殖期<35年或>40年都与虚弱的几率增加有关。绝经年龄(自然或手术年龄)与虚弱几率之间存在负线性关系。手术绝经与身体虚弱的几率高30%(1.34,1.27-1.43)和综合虚弱的几率高30%(1.30,1.25-1.35)相关。有两个或三个孩子与身体虚弱(0.48,0.38-0.59)和全面虚弱(0.72,0.64-0.81)的可能性最低。经历流产增加了虚弱的几率。MHT的使用与自然绝经(45岁后)正常年龄的女性身体虚弱的几率增加有关,而在早期自然绝经服用MHT的女性中没有观察到升高的可能性。
结论:生殖因素是自我报告的,数据可能存在回忆偏差。我们缺乏有关MHT类型和启动时间的信息,无法识别后来怀孕的不孕妇女,不孕妇女的数量可能被低估了。参加英国生物银行的个人不能代表英国总人口,限制了我们发现的推广。
结论:女性在其整个生命过程中经历的生殖因素可能预测中老年的虚弱。确定这些生殖因素作为虚弱的潜在预测因素可以告知医疗保健提供者和政策制定者在评估女性虚弱风险时考虑女性生殖史的重要性。
背景:这项工作得到了国家重点研究发展计划(2022YFC2703800)的支持,国家自然科学基金(82273702),山东省优秀青年学者科学基金项目(海外)(2022HWYQ-030),泰山学者项目专项资金(编号:tsqnz20221103),和齐鲁青年学者(一级)计划(202099000066)。所有作者都没有利益冲突要声明。
背景:不适用。
OBJECTIVE: Are women\'s reproductive factors associated with physical frailty and comprehensive frailty in middle-age and later life?
CONCLUSIONS: Early menarche at <13 years, age at menopause <45 years, surgical menopause, experiencing miscarriage and a shorter reproductive period of <35 years were associated with increased odds of frailty, while having two or three children was related to decreased likelihood of frailty.
BACKGROUND: Evidence has shown that women are frailer than men in all age groups and across different populations, although women have longer lifespans. Female-specific reproductive factors may be related to risk of frailty in women.
UNASSIGNED: A population-based cross-sectional study involved 189 898 women from the UK Biobank.
METHODS: Frailty phenotype and frailty index were used to assess physical frailty and comprehensive frailty (assessed using 38 health indicators for physical and mental wellbeing), respectively. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% CI between reproductive factors and likelihood of physical frailty and comprehensive frailty. Restricted cubic spline models were used to test the non-linear associations between them. In addition, we examined the combined effect of categorized age at menopause and menopause hormone therapy (MHT) on frailty.
RESULTS: There was a J-shape relationship between age at menarche, reproductive period, and frailty; age at menarche <13 years and >16 years, and reproductive period <35 years or >40 years were all associated with increased odds of frailty. There was a negative linear relationship between menopausal age (either natural or surgical) and odds of frailty. Surgical menopause was associated with 30% higher odds of physical frailty (1.34, 1.27-1.43) and 30% higher odds of comprehensive frailty (1.30, 1.25-1.35). Having two or three children was linked to the lowest likelihood of physical frailty (0.48, 0.38-0.59) and comprehensive frailty (0.72, 0.64-0.81). Experiencing a miscarriage increased the odds of frailty. MHT use was linked to increased odds of physical frailty in women with normal age at natural menopause (after 45 years), while no elevated likelihood was observed in women with early natural menopause taking MHT.
CONCLUSIONS: The reproductive factors were self-reported and the data might be subject to recall bias. We lacked information on the types and initiation time of MHT, could not identify infertile women who later became pregnant, and the number of infertile women may be underestimated. Individuals participating in the UK Biobank are not representative of the general UK population, limiting the generalization of our findings.
CONCLUSIONS: The reproductive factors experienced by women throughout their life course can potentially predict frailty in middle and old age. Identifying these reproductive factors as potential predictors of frailty can inform healthcare providers and policymakers about the importance of considering a woman\'s reproductive history when assessing their risk for frailty.
BACKGROUND: This work was supported by the National Key Research and Development Program of China (2022YFC2703800), National Natural Science Foundation of China (82273702), Science Fund Program for Excellent Young Scholars of Shandong Province (Overseas) (2022HWYQ-030), Taishan Scholars Project Special Fund (No. tsqnz20221103), and the Qilu Young Scholar (Tier-1) Program (202099000066). All authors have no conflicts of interest to declare.
BACKGROUND: N/A.