Chinese General Practice ›› 2019, Vol. 22 ›› Issue (5): 595-600.DOI: 10.12114/j.issn.1007-9572.2018.00.255

Special Issue: 女性健康最新文章合集

• Monographic Research • Previous Articles     Next Articles

Association between Number of Abortions and Metabolic Syndrome

  

  1. Department of Endocrinology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China
    *Corresponding author:WAN Qin,Master supervisor;E-mail:wanqin3@163.com
  • Published:2019-02-15 Online:2019-02-15

女性流产次数对代谢综合征的影响研究

  

  1. 646000四川省泸州市,西南医科大学附属医院内分泌科
    *通信作者:万沁,硕士生导师;E-mail:wanqin3@163.com

Abstract: Backgroud In recent years,the prevalence of metabolic syndrome(MS)is on the rise.However,the etiology of MS is not yet clear,it is now believed to be the result of interaction between multiple genes and multiple environmental factors.The epidemiological studies on the association between number of abortions and the prevalence of MS are very limited now.Objective To investigate the association between number of abortions and the prevalence of MS.Methods Totaled 2 829 women with complete data who participated in the epidemiological investigation of type 2 diabetes in Luzhou region from 2014 to 2016 were selected.Clinical data were collected through a questionnaire survey.All of them underwent physical examination and laboratory test and the results were recorded.Multivariate Logistic regression was used to investigate the association between the number of abortions and the prevalence of MS.Results Of the 2 829 participants,1 089 had MS(38.49%).There were significant differences in distribution of number of abortions and artificial abortions between patients with MS and those without MS (P<0.05).Compared with those without MS,the average age,average body mass index(BMI),waist circumference (WC),hip circumference (HC),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin (HbA1c),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),alanine aminotransferase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT) and creatinine levels increased but the prevalence of alcohol drinking and average high-density lipoprotein cholesterol (HDL-C) levels decreased significantly in those with MS(P<0.05).Multivariate Logistic regression analysis showed that,after adjusting for age,drinking,BMI,WC,HC,SBP,DBP,FPG,2 hPG,HbA1c,TC,TG,HDL-C,LDL-C,ALT,AST,GGT and creatinine levels,the prevalence of MS in women with one,two,three,more than three times of abortion increased by a factor of 1.582〔95%CI(1.096,2.284),P=0.014〕,1.680〔95%CI(1.148,2.456),P=0.008〕,2.259〔95%CI(1.440,3.545),P<0.001〕,2.266〔95%CI(1.355,3.789),P=0.002〕,respectively,compared with those without a history of abortion.The prevalence of MS in women with one,two,three,more than three times of artificial abortion increased by a factor of 1.465〔95%CI(1.026,2.091),P=0.035〕,1.689〔95%CI(1.156,2.469),P=0.007〕,2.151〔95%CI(1.369,3.380),P=0.001〕,1.947〔95%CI(1.144,3.315),P=0.014〕,respectively,compared with those without a history of artificial abortion.Conclusion History of abortion/ artificial abortion is strongly associated with an increased risk of MS,and the association is number-dependent.

Key words: Metabolic syndrome X, Abortion, Risk factors

摘要: 背景 近年来,代谢综合征的患病率呈上升趋势,然而代谢综合征病因尚未明确,目前认为是多基因和多种环境因素相互作用的结果。目前关于流产史与代谢综合征的流行病学研究非常有限。目的 探讨女性流产次数对代谢综合征的影响。方法 选取2014—2016年参与泸州地区2型糖尿病流行病学调查的2 829例资料完整的女性,问卷调查一般资料,记录体格检查、实验室检查结果。采用Logistic回归分析流产次数对代谢综合征的影响。结果 2 829人中发生代谢综合征1 089人(38.49%)。发生代谢综合征与未发生代谢综合征流产次数分布、人工流产次数分布比较,差异均有统计学意义(P<0.05);发生代谢综合征者年龄、体质指数(BMI)、腰围、臀围、收缩压、舒张压、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、肌酐水平高于未发生代谢综合征者,饮酒率、高密度脂蛋白胆固醇(HDL-C)水平低于未发生代谢综合征者(P<0.05)。多因素Logistic回归分析显示,在控制年龄、饮酒、BMI、腰围、臀围、收缩压、舒张压、FPG、2 hPG、HbA1c、TC、TG、HDL-C、LDL-C、ALT、AST、GGT、肌酐水平等影响后,有1次、2次、3次及>3次流产史女性发生代谢综合征分别是无流产史女性的1.582〔95%CI(1.096,2.284),P=0.014〕、1.680〔95%CI(1.148,2.456),P=0.008〕、2.259〔95%CI(1.440,3.545),P<0.001〕、2.266〔95%CI(1.355,3.789),P=0.002〕倍;有1次、2次、3次及>3次人工流产史女性发生代谢综合征分别是无人工流产史女性的1.465〔95%CI(1.026,2.091),P=0.035〕、1.689〔95%CI(1.156,2.469),P=0.007〕、2.151〔95%CI(1.369,3.380),P=0.001〕、1.947〔95%CI(1.144,3.315),P=0.014〕倍。结论 女性流产次数及人工流产次数与代谢综合征的发生有相关性,并且随着女性流产次数的增加,代谢综合征的发生风险增高。

关键词: 代谢综合征X, 流产, 危险因素