基于前瞻性人群队列的中国成年人排便频率与帕金森病的关联研究

杨淞淳; 樊萌语; 余灿清; 郭彧; 卞铮; 裴培; 陈君石; 陈铮鸣; 吕筠; 李立明

Abstract

杨淞淳,樊萌语,余灿清,郭彧,卞铮,裴培,陈君石,陈铮鸣,吕筠,李立明.基于前瞻性人群队列的中国成年人排便频率与帕金森病的关联研究[J].Chinese journal of Epidemiology,2020,41(1):48-54

基于前瞻性人群队列的中国成年人排便频率与帕金森病的关联研究

Frequency of bowel movements and risk of Parkinson's disease: a prospective cohort study in adults in China

Received:May 17, 2019

DOI：10.3760/cma.j.issn.0254-6450.2020.01.010

KeyWord: 排便帕金森病队列研究

English Key Word: Defecation Parkinson disease Cohort studies

FundProject:国家自然科学基金（91846303）；国家重点研发计划精准医学研究重点专项（2016YFC0900500，2016YFC0900501，2016YFC0900504）；中国香港Kadoorie Charitable基金；英国Wellcome Trust（202922/Z/16/Z，088158/Z/09/Z，104085/Z/14/Z）

Author Name	Affiliation	E-mail
Yang Songchun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Fan Mengyu	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Guo Yu	Chinese Academy of Medical Sciences, Beijing 100730, China
Bian Zheng	Chinese Academy of Medical Sciences, Beijing 100730, China
Pei Pei	Chinese Academy of Medical Sciences, Beijing 100730, China
Chen Junshi	China National Center for Food Safety Risk Assessment, Beijing 100022, China
Chen Zhengming	Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Peking University, Beijing 100191, China	lvjun@bjmu.edu.cn
Li Liming	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China

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Abstract:

目的检验成年人排便频率与随访期间确定的帕金森病的关联。方法研究对象来自于中国慢性病前瞻性研究，2004-2008年开展基线调查。在剔除基线自报患有恶性肿瘤者后，最终纳入510 134人。随访截止到2016年12月31日，采用Cox比例风险回归模型计算排便频率和帕金森病的关联。结果研究对象随访（9.9±1.9）年，随访期间诊断帕金森病共808例。在全人群中，控制潜在混杂因素后，与排便频率1次/d者相比，排便频率<3次/周者、隔天1次者、>1次/d者随访期间出现帕金森病诊断的HR值（95%CI）分别为3.62（2.88~4.54）、2.13（1.74~2.60）和0.81（0.63~1.05），排便频率与帕金森病诊断之间的关联存在有统计学意义的线性趋势（P<0.001）。与排便频率≥ 1次/d者相比，排便频率<1次/d者的HR值（95%CI）在随访≤ 5年内为3.13（2.32~4.23），在随访>5年后为2.48（2.05~3.01）。分性别分析时的结果与全人群中相似。排便频率<1次/d与帕金森病诊断的关联在老年人中更强。结论基线排便频率越低的研究对象在未来平均10年的随访期内出现帕金森病诊断的风险越高。低排便频率作为一个容易识别的症状，可结合其他与帕金森病相关的早期症状，用于老年人群中帕金森病的早期发现。

English Abstract:

Objective To evaluate the association between the frequency of bowel movement (BMF) and the risk of Parkinson's disease (PD). Methods In this study, 510 134 participants from the China Kadoorie Biobank (CKB) were included after excluding those who reported to had been diagnosed with cancer at baseline survey. The baseline survey was conducted from 2004 to 2008. The study used the data from the baseline survey and follow-up until December 31, 2016. Cox proportional hazards regression models were used to estimate the HRs and the 95%CIs of risk of PD diagnosis with BMF. Results During an average follow-up period of (9.9±1.9) years, 808 participants were diagnosed with PD. Compared with participants who had bowel movements every day, the multivariable-adjusted HR (95%CI) for those who had bowel movements <3 times/week, once every 2-3 days, and >1 time/day were 3.62 (2.88-4.54), 2.13 (1.74-2.60), and 0.81 (0.63-1.05), respectively. The linear trend test results of the association between BMF and risk of PD diagnosis was significant (P<0.001). Compared with the participants who had bowel movements ≥ 1 time/day, the multivariable-adjusted HR (95%CI) for those who had bowel movements <1 time/day was 3.13 (2.32-4.23) within the 5 years of follow-up and was 2.48 (2.05-3.01) beyond the 5 years of follow-up. The gender specific results were similar. The association of BMF <1 time/day with risk of PD diagnosis was stronger in older participants. Conclusions The participants with low BMF at baseline survey would have higher risk for PD diagnosis in the subsequent 10 years on average. Since abnormal decrease of BMF is easy to be found, programs could be set up for the early screening of PD in older people, along with other early symptoms of PD.

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