Le Pluart D, Sabaté J-M, Bouchoucha M, Hercberg S, Benamouzig R, Julia C
Université Paris 13, Sorbonne Paris Cité, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Biostatistiques (CRESS), UMR 1153 Inserm, U1125 Inra, Cnam, COMUE Sorbonne Paris Cité, Bobigny, France.
Aliment Pharmacol Ther. 2015 Apr;41(8):758-67. doi: 10.1111/apt.13143. Epub 2015 Mar 1.
Functional gastrointestinal disorders' (FGIDs) associations with body mass index (BMI) have not been thoroughly investigated in the general population.
To investigate the overlap between functional dyspepsia (FDy), irritable bowel syndrome (IBS), functional constipation (FC) and functional diarrhoea (FDh) and the relationship between BMI and those diagnoses in a large French adult population.
Subjects participating in the Nutrinet-Santé cohort study completed a questionnaire based on Rome III criteria. Anthropometrics, socio-demographical and lifestyle data were collected via self-administered questionnaires. Associations between BMI and FGIDs were investigated with multivariate logistic regression.
A total of 35 447 subjects were included in the analysis. Among subjects with FGIDs, 10.4% presented more than one disorder. [FDy coexisted with IBS (23.6%) and FC (15.1%)]. Associations between BMI and FDy differed according to sex. In females, higher odds were observed for underweight and obesity subgroups (OR = 1.26 (95% CI: 0.99-1.59), OR = 1.35 (1.08-1.69), OR = 1.20 (0.81-1.77), OR = 1.47 (0.89-2.42) for underweight, class I, II and III obesity respectively compared with normal BMI), forming a U-shaped relationship confirmed with nonlinear model (P < 0.001). In females, FDh was associated with BMI [OR = 1.05 (1.03-1.07), P < 0.001]. In males, a negative association between BMI and IBS was observed [OR = 0.97 (0.94-0.99), P=0.04]. Other associations were not significant.
Our study showed an important overlap in FGIDs, supporting the contention of common pathophysiological mechanisms. Relationships between BMI and FGIDs appeared to be sex-dependent. Interaction by sex in the association between BMI and FGIDs should therefore be further explored.
在普通人群中，功能性胃肠疾病（FGIDs）与体重指数（BMI）之间的关联尚未得到充分研究。
在法国大量成年人群中，研究功能性消化不良（FDy）、肠易激综合征（IBS）、功能性便秘（FC）和功能性腹泻（FDh）之间的重叠情况以及BMI与这些诊断之间的关系。
参与Nutrinet-Santé队列研究的受试者完成了一份基于罗马III标准的问卷。通过自行填写问卷收集人体测量学、社会人口统计学和生活方式数据。采用多因素逻辑回归研究BMI与FGIDs之间的关联。
共有35447名受试者纳入分析。在患有FGIDs的受试者中，10.4%存在不止一种疾病。[FDy与IBS（23.6%）和FC（15.1%）共存]。BMI与FDy之间的关联因性别而异。在女性中，体重过轻和肥胖亚组的患病几率更高（与正常BMI相比，体重过轻、I级、II级和III级肥胖的OR分别为1.26（95%CI：0.99-1.59）、1.35（1.08-1.69）、1.20（0.81-1.77）、1.47（0.89-2.42）），非线性模型证实呈U形关系（P<0.001）。在女性中，FDh与BMI相关[OR=1.05（1.03-1.07），P<0.001]。在男性中，观察到BMI与IBS之间存在负相关[OR=0.97（0.94-0.99），P=0.04]。其他关联不显著。
我们的研究表明FGIDs之间存在重要重叠，支持共同病理生理机制的观点。BMI与FGIDs之间的关系似乎存在性别依赖性。因此，应进一步探讨BMI与FGIDs关联中的性别交互作用。
