본문 바로가기
KERD
논문KCI 등재

Association between History of Pregnancy and Liver Fibrosis Using Fibrosis-4 Index in Korean Postmenopausal Women: A Nationwide Population-Based Study

0

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류가정의학

초록

Background: The association between a history of pregnancy and liver fibrosis remains unclear. Herein, we investigated the association between reproductive factors, including a history of pregnancy and liver fibrosis, in postmenopausal Korean women.Methods: This study used nationally representative, population-based data collected from the Korea National Health and Nutrition Examination Survey 2008–2017. Of 14,624 women with natural menopause, 11,085 with no previous history of any type of cancer, hepatitis, or chronic heavy alcohol consumption were enrolled. We investigated the reproductive factors, including a history of pregnancy, total reproductive years, age at menarche and menopause, and oral contraceptive use. Liver fibrosis was defined as a Fibrosis-4 index score ≥2.67 kg/m<sup>2</sup>.Results: Of the study participants, 372 (3.3%) had advanced liver fibrosis. Multivariable logistic regression analysis showed that women with a history of more than one pregnancy were associated with a lower risk of liver fibrosis compared to women who had never been pregnant, after adjusting for potential confounders (adjusted odds ratio, 0.30; 95% confidence interval, 0.15–0.59). The risk of liver fibrosis did not increase significantly with an increasing number of pregnancies (P for trend=0.135). Other reproductive factors, including total reproductive years, age at menopause and menarche, and oral contraceptive use, were not significantly associated with liver fibrosis.Conclusion: Postmenopausal women who had experienced one or more pregnancies had a reduced risk of liver fibrosis. Our findings reveal a potential protective role of pregnancy against liver fibrosis.

Abstract

Background: The association between a history of pregnancy and liver fibrosis remains unclear. Herein, we investigated the association between reproductive factors, including a history of pregnancy and liver fibrosis, in postmenopausal Korean women.Methods: This study used nationally representative, population-based data collected from the Korea National Health and Nutrition Examination Survey 2008–2017. Of 14,624 women with natural menopause, 11,085 with no previous history of any type of cancer, hepatitis, or chronic heavy alcohol consumption were enrolled. We investigated the reproductive factors, including a history of pregnancy, total reproductive years, age at menarche and menopause, and oral contraceptive use. Liver fibrosis was defined as a Fibrosis-4 index score ≥2.67 kg/m<sup>2</sup>.Results: Of the study participants, 372 (3.3%) had advanced liver fibrosis. Multivariable logistic regression analysis showed that women with a history of more than one pregnancy were associated with a lower risk of liver fibrosis compared to women who had never been pregnant, after adjusting for potential confounders (adjusted odds ratio, 0.30; 95% confidence interval, 0.15–0.59). The risk of liver fibrosis did not increase significantly with an increasing number of pregnancies (P for trend=0.135). Other reproductive factors, including total reproductive years, age at menopause and menarche, and oral contraceptive use, were not significantly associated with liver fibrosis.Conclusion: Postmenopausal women who had experienced one or more pregnancies had a reduced risk of liver fibrosis. Our findings reveal a potential protective role of pregnancy against liver fibrosis.

참고문헌 (33)

  1. Mokdad AA, "Liver cirrhosis mortality in 187 countries between 1980 and 2010 : a systematic analysis", BMC Med, 12, pp.145~ (2014)
  2. Bataller R, "Liver fibrosis", J Clin Invest, 115, pp.209~218 (2005)
  3. Altamirano-Barrera A, "Management strategies for liver fibrosis", Ann Hepatol, 16, pp.48~56 (2017)
  4. Yang JD, "Gender and menopause impact severity of fibrosis among patients with nonalcoholic steatohepatitis", Hepatology, 59, pp.1406~1414 (2014)
  5. Di Martino V, "Progression of liver fibrosis in women infected with hepatitis C : long-term benefit of estrogen exposure", Hepatology, 40, pp.1426~1433 (2004)
  6. Codes L, "Chronic hepatitis C and fibrosis : evidences for possible estrogen benefits", Braz J Infect Dis, 11, pp.371~374 (2007)
  7. Villa E, "Reproductive status is associated with the severity of fibrosis in women with hepatitis C", PLoS One, 7, pp.e44624~ (2012)
  8. Pfeilschifter J, "Changes in proinflammatory cytokine activity after menopause", Endocr Rev, 23, pp.90~119 (2002)
  9. Belli LS, "Liver transplantation for HCV cirrhosis : improved survival in recent years and increased severity of recurrent disease in female recipients : results of a long term retrospective study", Liver Transpl, 13, pp.733~740 (2007)
  10. Lai JC, "Hepatitis C virus-infected women have a higher risk of advanced fibrosis and graft loss after liver transplantation than men", Hepatology, 54, pp.418~424 (2011)
  11. Brady CW, "Liver disease in menopause", World J Gastroenterol, 21, pp.7613~7620 (2015)
  12. Pinzani M, "Technology Insight : noninvasive assessment of liver fibrosis by biochemical scores and elastography", Nat Clin Pract Gastroenterol Hepatol, 5, pp.95~106 (2008)
  13. Shah AG, "Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 7, pp.1104~1112 (2009)
  14. Kaswala DH, "Fibrosis assessment in Nonalcoholic Fatty Liver Disease(NAFLD)in 2016", Dig Dis Sci, 61, pp.1356~1364 (2016)
  15. Halfon P, "Prospective screening of liver fibrosis in a primary care cohort using systematic calculation of FIB-4 in routine results", PLoS One, 16, pp.e0254939~ (2021)
  16. Ahn K, "FIB-4 score as a useful screening test for diagnosing liver fibrosis", J Lab Med Qual Assur, 39, pp.16~22 (2017)
  17. Lee YH, "Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease : nationwide surveys(KNHANES 2008-2011)", Hepatology, 63, pp.776~786 (2016)
  18. Jung JY, "Serum ferritin level is associated with liver steatosis and fibrosis in Korean general population", Hepatol Int, 13, pp.222~233 (2019)
  19. Chung SM, "The sex-specific effects of blood lead, mercury, and cadmium levels on hepatic steatosis and fibrosis : Korean nationwide cross-sectional study", J Trace Elem Med Biol, 62, pp.126601~ (2020)
  20. Seung Ha Park, "Trends in the prevalence of chronic liver disease in the Korean adult population, 1998–2017", Clinical and Molecular Hepatology, 26(2), pp.209~215 (2020), 대한간학회[DOI]
  21. Park SH, "Lack of association between early menopause and non-alcoholic fatty liver disease in postmenopausal women", Climacteric, 23, pp.173~177 (2020)
  22. Han E, "Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes", Medicine(Baltimore), 99, pp.e21038~ (2020)
  23. Fontaine H, "Effect of pregnancy on chronic hepatitis C : a case-control study", Lancet, 356, pp.1328~1329 (2000)
  24. Nah EH, "Prevalence of liver fibrosis and associated risk factors in the Korean general population : a retrospective cross-sectional study", BMJ Open, 11, pp.e046529~ (2021)
  25. Imajo K, "Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography", Gastroenterology, 150, pp.626~637.e7 (2016)
  26. Klair JS, "A longer duration of estrogen deficiency increases fibrosis risk among postmenopausal women with nonalcoholic fatty liver disease", Hepatology, 64, pp.85~91 (2016)
  27. Shimizu I, "Female hepatology : favorable role of estrogen in chronic liver disease with hepatitis B virus infection", World J Gastroenterol, 13, pp.4295~4305 (2007)
  28. Yasuda M, "Suppressive effects of estradiol on dimethylnitrosamine-induced fibrosis of the liver in rats", Hepatology, 29, pp.719~727 (1999)
  29. Schock H, "Hormone concentrations throughout uncomplicated pregnancies : a longitudinal study", BMC Pregnancy Childbirth, 16, pp.146~ (2016)
  30. Kuijper EA, "Reproductive hormone concentrations in pregnancy and neonates : a systematic review", Reprod Biomed Online, 27, pp.33~63 (2013)
  31. O’Leary P, "Longitudinal assessment of changes in reproductive hormones during normal pregnancy", Clin Chem, 37, pp.667~672 (1991)
  32. Kim BK, "Validation of FIB-4 and comparison with other simple noninvasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus-infected patients", Liver Int, 30, pp.546~553 (2010)
  33. Sterling RK, "Development of a simple noninvasive index to predict significant fibrosis in patients with HIV", HCV coinfection, 2006, pp.43, 1317~1325

관련 논문AI추천

Association between Liver Function Markers and Menstrual Cycle Irregularity in Korean Female PopulationBaek Chae-Won, Kim Do-Hoon, Kim Hye-In, Kim Hyun-Jin, Lee An-Na, Lee Min-Hae, Park Joo-Hyun, Shin Jung-Hwa대한가정의학회 · Korean Journal of Family Medicine2025 · 제46권 제5호Systematic review with meta-analysis: Non-alcoholic fatty liver disease and the association with pregnancy outcomesGuy D Eslick, Hydar El Jamaly, Martin Weltman대한간학회 · Clinical and Molecular Hepatology2022 · 제28권 제1호Characteristic Features of Nonalcoholic Fatty Liver Disease in Japan with a Focus on the Roles of Age, Sex and Body Mass IndexEtsuko Hashimoto, Maki Tobari거트앤리버 소화기연관학회협의회 · Gut and Liver2020 · 제14권 제5호Sex Difference in the Association between Serum Homocysteine Level and Non-Alcoholic Fatty Liver DiseaseBo-Youn Won, Hye-Jung Kim, Hyung-Yuk Kim, Ji-Hee Haam, Ki-Hyun Park, Kye-Seon Park, Kyung-Chae Park, Moon-Jong Kim, Soo-Hyun Lee, Sung-Hwan Yun, Young-Sang Kim대한가정의학회 · Korean Journal of Family Medicine2016 · 제37권 제4호Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea성지선, 송윤미, 정해관, Seung Ho Ryu대한예방의학회 · 예방의학회지2020 · 제53권 제5호Effects of Age at First Childbirth and Other Factors on Central Obesity in Postmenopausal Women: The 2013–2015 Korean National Health and Nutrition Examination Survey광병규, 윤정원, 이왕진, 이주하, 장신해, 최유진대한가정의학회 · Korean Journal of Family Medicine2018 · 제39권 제3호

이 간행물의 다른 논문 (8건)