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已发表论文
65 岁及以上女性生殖期与全因及心血管疾病死亡率之间的关联：基于 1999 - 2018 年美国国家健康与营养调查数据的队列研究
Authors Chen X, Li C , Bai Y, Li L
Received 17 September 2025
Accepted for publication 19 December 2025
Published 25 December 2025 Volume 2025:17 Pages 5609—5622
DOI https://doi.org/10.2147/IJWH.S568174
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Everett Magann
Xiaohui Chen, Chunxue Li, Yue Bai, Lin Li
Department of Cardiovascular, The Second Hospital of Jilin University, Changchun, People’s Republic of China
Correspondence: Lin Li, Department of Cardiovascular, The Second Hospital of Jilin University, No. 218, Zi Qiang Street, Nanguan Zone, Changchun, Jilin, 130041, People’s Republic of China, Tel +8619975320351, Email lilin607268@jlu.edu.cn
Purpose: The association between reproductive lifespan and all-cause and cardiovascular mortality in women aged ≥ 65 years remains unclear. We examined this association in a nationally representative sample of older US women using NHANES data.
Patients and Methods: The study included postmenopausal women aged 65 years and older from the NHANES database as our study cohort. Throughout the analyses, NHANES sampling weights were applied to account for the complex survey design, and multiple imputation were used to deal with missing values. Multivariable Cox regression, restricted cubic splines, Kaplan–Meier survival curves, and subgroup analyses were used to estimate the associations between reproductive lifespan and both all-cause and cardiovascular mortality. Additionally, sensitivity analyses were performed to verify the robustness of the results.
Results: Among 4514 participants followed for a median of 101 months, all-cause mortality occurred in 1843 (38.67%) and cardiovascular mortality in 512 (10.74%). A linear relationship was observed between reproductive lifespan and all-cause mortality; in the fully adjusted model, for each additional year of reproductive lifespan, the risk of all-cause mortality decreased by 1% (HR = 0.99, 95% CI 0.98– 0.99, p < 0.001). Conversely, the relationship between reproductive lifespan and cardiovascular mortality followed an L-shaped curve. Further threshold-effect analysis identified an inflection point at 36 years: for reproductive lifespan < 36 years, each additional year conferred a 2% reduction in cardiovascular mortality risk (HR = 0.98, 95% CI 0.95– 1.00, p = 0.033), whereas the protective effect plateaued when reproductive lifespan ≥ 36 years.
Conclusion: Short reproductive lifespan may be associated with an increased risk of all-cause and cardiovascular mortality. Greater attention should be given to women with a short reproductive lifespan.
Keywords: reproductive lifespan, all-cause mortality, cardiovascular mortality, NHANES, cohort study
Department of Cardiovascular, The Second Hospital of Jilin University, Changchun, People’s Republic of China
Correspondence: Lin Li, Department of Cardiovascular, The Second Hospital of Jilin University, No. 218, Zi Qiang Street, Nanguan Zone, Changchun, Jilin, 130041, People’s Republic of China, Tel +8619975320351, Email lilin607268@jlu.edu.cn
Purpose: The association between reproductive lifespan and all-cause and cardiovascular mortality in women aged ≥ 65 years remains unclear. We examined this association in a nationally representative sample of older US women using NHANES data.
Patients and Methods: The study included postmenopausal women aged 65 years and older from the NHANES database as our study cohort. Throughout the analyses, NHANES sampling weights were applied to account for the complex survey design, and multiple imputation were used to deal with missing values. Multivariable Cox regression, restricted cubic splines, Kaplan–Meier survival curves, and subgroup analyses were used to estimate the associations between reproductive lifespan and both all-cause and cardiovascular mortality. Additionally, sensitivity analyses were performed to verify the robustness of the results.
Results: Among 4514 participants followed for a median of 101 months, all-cause mortality occurred in 1843 (38.67%) and cardiovascular mortality in 512 (10.74%). A linear relationship was observed between reproductive lifespan and all-cause mortality; in the fully adjusted model, for each additional year of reproductive lifespan, the risk of all-cause mortality decreased by 1% (HR = 0.99, 95% CI 0.98– 0.99, p < 0.001). Conversely, the relationship between reproductive lifespan and cardiovascular mortality followed an L-shaped curve. Further threshold-effect analysis identified an inflection point at 36 years: for reproductive lifespan < 36 years, each additional year conferred a 2% reduction in cardiovascular mortality risk (HR = 0.98, 95% CI 0.95– 1.00, p = 0.033), whereas the protective effect plateaued when reproductive lifespan ≥ 36 years.
Conclusion: Short reproductive lifespan may be associated with an increased risk of all-cause and cardiovascular mortality. Greater attention should be given to women with a short reproductive lifespan.
Keywords: reproductive lifespan, all-cause mortality, cardiovascular mortality, NHANES, cohort study