Abbott R D, Petrovitch H, White L R, Masaki K H, Tanner C M, Curb J D, Grandinetti A, Blanchette P L, Popper J S, Ross G W
Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, USA.
Neurology. 2001 Aug 14;57(3):456-62. doi: 10.1212/wnl.57.3.456.
Constipation is frequent in PD, although its onset in relation to clinical PD has not been well described. Demonstration that constipation can precede clinical PD could provide important clues to understanding disease progression and etiology. The purpose of this report is to examine the association between the frequency of bowel movements and the future risk of PD.
Information on the frequency of bowel movements was collected from 1971 to 1974 in 6790 men aged 51 to 75 years without PD in the Honolulu Heart Program. Follow-up for incident PD occurred over a 24-year period.
Ninety-six men developed PD an average of 12 years into follow-up. Age-adjusted incidence declined consistently from 18.9/10,000 person-years in men with <1 bowel movement/day to 3.8/10,000 person-years in those with >2/day (p = 0.005). After adjustment for age, pack-years of cigarette smoking, coffee consumption, laxative use, jogging, and the intake of fruits, vegetables, and grains, men with <1 bowel movement/day had a 2.7-fold excess risk of PD versus men with 1/day (95% CI: 1.3, 5.5; p = 0.007). The risk of PD in men with <1 bowel movement/day increased to a 4.1-fold excess when compared with men with 2/day (95% CI: 1.7, 9.6; p = 0.001) and to a 4.5-fold excess versus men with >2/day (95% CI: 1.2, 16.9; p = 0.025).
Findings indicate that infrequent bowel movements are associated with an elevated risk of future PD. Further study is needed to determine whether constipation is part of early PD processes or is a marker of susceptibility or environmental factors that may cause PD.
便秘在帕金森病（PD）患者中很常见，尽管其与临床PD发病的关系尚未得到充分描述。证明便秘可先于临床PD出现，可能为理解疾病进展和病因提供重要线索。本报告的目的是研究排便频率与未来发生PD风险之间的关联。
在檀香山心脏项目中，于1971年至1974年收集了6790名年龄在51至75岁且无PD的男性的排便频率信息。对PD发病情况进行了为期24年的随访。
96名男性在随访期间平均12年时发生了PD。年龄调整后的发病率从每天排便少于1次的男性中的18.9/10000人年持续下降至每天排便多于2次的男性中的3.8/10000人年（p = 0.005）。在对年龄、吸烟包年数、咖啡摄入量、泻药使用、慢跑以及水果、蔬菜和谷物摄入量进行调整后，每天排便少于1次的男性发生PD的风险是每天排便1次的男性的2.7倍（95%置信区间：1.3，5.5；p = 0.007）。与每天排便2次的男性相比，每天排便少于1次的男性发生PD的风险增加至4.1倍（95%置信区间：1.7，9.6；p = 0.001），与每天排便多于2次的男性相比则增加至4.5倍（95%置信区间：1.2，16.9；p = 0.025）。
研究结果表明排便频率低与未来发生PD的风险升高有关。需要进一步研究以确定便秘是早期PD过程的一部分，还是易感性或可能导致PD的环境因素的标志物。
