| Title: | Associations between female sex-specific risk factors and cardiometabolic multimorbidity: evidence from the UK Biobank cohort study |
| Journal: | BMC Public Health |
| Published: | 12 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42277788/ |
| DOI: | https://doi.org/10.1186/s12889-026-28116-3 |
Publication 20779
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BackgroundHormonal changes throughout life in women are associated with menarche, pregnancy, lactation, and menopause. Cardiometabolic multimorbidity (CMM) has become increasingly common with population aging. However, the impact of such fluctuations on CMM has not been evaluated. This study aims to investigate the associations of female sex-specific risk factors with CMM and four cardiometabolic diseases.MethodsA total of 248,623 women from the UK Biobank without pre-existing cardiometabolic disease were included. Cox proportional hazard models were used to evaluate the association between female-specific risk factors and the incidence of CMM and the four cardiometabolic diseases. The UpSet plots were used to visualize combinations of female-specific risk factors, and then to evaluate the association between the combinations and accumulations of female risk factors and CMM.ResultsThe average age of participants was 56.4 years, with a median follow-up period of 13.6 years. After adjusting for multiple variables, early menarche was associated with an 11% higher risk for CMM incidence (HR, 1.11; 95% CI, 1.06-1.15). Early menopause (age < 35 years: HR, 1.80; 95% CI, 1.58-2.06; age 35-44 years: HR, 1.24; 95% CI, 1.17-1.32; age 45-49 years: HR, 1.09; 95% CI, 1.04-1.15), younger maternal age at first (age < 21 years: HR, 1.35; 95% CI, 1.28-1.42; age 21-25 years: HR, 1.13; 95% CI, 1.08-1.18) and last (age < 26 years: HR, 1.12; 95% CI, 1.06-1.18) live birth were associated with increased CMM risk, respectively. Women with three or more children had a higher risk of developing CMM (3 children: HR, 1.05; 95% CI, 1.00-1.10; ≥ 4 children HR, 1.19; 95% CI, 1.13-1.27). Additionally, a history of two or more stillbirths (HR, 1.30; 95% CI, 1.07-1.59) or spontaneous miscarriages (HR, 1.24; 95% CI, 1.15-1.34) was associated with elevated CMM risk, with similar findings for each cardiometabolic disease. Combinations or accumulations of sex-specific risk factors are associated with an increased risk of CMM.ConclusionsIn summary, female sex-specific factors significantly influence the incidence of both CMM and each cardiometabolic disease.</p>
8 Authors
- Li Mao
- Lijin Lin
- Fang Lei
- Yu Tian
- Guoying Wang
- Jinxing He
- Juan Wan
- Hui Liu
Enabling scientific discoveries that improve human health