| Background The prevalence and mortality of coronary heart disease(CHD)in China are increasing,which is closely related to the change of risk factors for coronary heart disease.Statistics from previous large samples showed that the prevalence of CHD wassignificantly lower in women aged ≤50 than that in men.This may be due to theprotective effect of estrogen,and the prevalence of CHD in postmenopausal womenis gradually close to that of men with age.Therefore,exploring risk factors related to female is of great significance to guide the formulation of early prevention programs.Objective To explore the association between possible risk factors specific in women,especially the number of births with the prevalence of CHD and coronary lesion severity.Methods In this study,a total of 990 women who received coronary angiography in the department of cardiology of our hospital between January 2018 and December 2018 were selected.Baseline data were collected for all participants,including demographic information,behavioral lifestyle,past disease history.Participants were divided into CHD group and control group according to the results of coronary angiography and classified by the number of births(response 1、2、3 or≥4).Multi-line linear regression model was used to evaluate the association between the number of birth and CHD,and Logistic regression model was used to analyze the other risk factors for CHD.Gensini score was calculated to express the coronary lesion severity according to the results of coronary angiography.Finally,multiple linear regression and ordered Logistic regression models were used to assess the correlation between the number of birth and the other risk factors with coronary lesion severity.Result(1)Patients in the CHD group were older,more likely to be combined with cerebrovascular disease,hypertension,diabetes,and postmenopausal status,have shorter sleep duration and lower educational level.And the levels of neutrophil to lymphocyte ratio(NLR),high sensitive c-reactive protein(hs-CRP),cystatin C(Cys-c),glycosylated hemoglobin(Hb A1c),triglycerides(TG),Very low-density lipoprotein cholesterol(VLDL-C)were higher,while high-density lipoprotein cholesterol(HDL-C)were lower(all P < 0.05).Logistic regression analysis showed that menopausal status,increased levels of NLR,hs-CRP and Hb1 Ac were independent risk factors for coronary heart disease,the odd ratios with 95% confidence interval(ORs,95% CI)were 7.048(3.353-14.816),1.185(1.034-1.359),1.517(1.385-1.662)and 1.912(1.477-2.474),respectively.(2)The body mass index(BMI),the levels of NLR,hs-CRP,Cys-C,Hb A1 c and Free triiodothyronine(FT3)were associated with Gensini scores,and the patients with diabetes have higher Gensini scores(all P < 0.05).Logistic regression analysis showed that Diabetes and hs-CRP level were both positively correlated with Gensini scores,the adjusted β-coefficients(95% CI)were 10.071(0.456-19.685)and 3.303(1.380-5.227).(3)Age,duration of sleep,degree of education,BMI,history of cerebrovascular disease,hypertension,diabetes,menopause,coronary heart disease,the levels of NLR,hs-CRP,Cys-C,Hb A1 c,FT3 and Free thyroxine(FT4)were significant difference between the groups classified by the number of births(all p <0.05).Multivariate linear regression model showed that the number of births was positive correlated with the risk of CHD,compared with the women with 1 birth,the risk of CHD was increased with the number of birth,the ORs(95%CI)were 2.27(1.64-2.91)、5.37(4.48-6.26)and6.77(5.51-8.02)for those with 2 、3 and ≥4 births,respectively.The risk of CHD increased 2.53 times for each increase in birth.(4)The number of births was positive correlation with Gensini scores(r=0.102).In ordered logistic model,the number of births was associated with coronary lesion severity,compared with the women with 1 birth,the ORs(95%CI)were 2.51(1.00-6.30)and 2.92(1.10-7.75)for those with 3 or at least 4 births.The similar result was showed in the multiple linear regression model,the β(95%CI)were 20.77(0.23-41.30)and 22.9(1.03-44.94),respectively.Conclusions(1)The number of births was significantly associated with increasing risk of CHD in Chinese women,the risk was 2.53 times higher for every increased birth.This suggested that multiple birth may be a risk factor for CHD.In addition,the number of births was associated with coronary lesion severity,compared with women with 1birth,coronary lesion severity was higher in those with 3 or ≥4 births.(2)Menopausal status and high levels of NLR,hs-CRP and Hb1 Ac were also independent risk factors for CHD in female.Diabetes and hs-CRP level were positively correlated with coronary lesion severity. |
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