Gastroenterology Division, National Hospital Organization Yokohama Medical Center, Yokohama, Japan.
Diabetes and Endocrinology Division, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan.
J Gastroenterol Hepatol. 2018 Apr;33(4):863-868. doi: 10.1111/jgh.14022. Epub 2018 Jan 18.
Changes in treatment protocols for patients with diabetes mellitus (DM) may influence the functions of the digestive tract. This study examined possible clinical factors associated with the symptoms of constipation in patients with DM.
This was a multicenter study. Participants were consecutive Japanese patients undergoing treatment for type 1 or type 2 DM. Constipation was evaluated using the gastrointestinal symptom rating scale. Diabetic neuropathy was evaluated by the presence or absence of peripheral neuropathy of the lower limbs.
Of 419 participants, 258 were men and 161 women (ratio: 1.6:1), with a mean age of 63.6 ± 12.5 years. In multivariate analysis, symptoms of constipation were significantly associated with age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.01-1.04, P = 0.032), lower mental component summary (OR = 3.31, 95% CI: 1.69-6.48, P < 0.001), diabetic retinopathy (OR = 1.99, 95% CI: 1.14-3.45, P = 0.015), and diabetic neuropathy (OR = 1.86, 95% CI: 1.10-3.16, P = 0.021). In patients with peripheral neuropathy of the lower limbs, regardless of the presence of other complications (diabetic nephropathy and diabetic retinopathy), the prevalence of symptoms of constipation was twice that of patients without peripheral neuropathy (40.0-49.1% vs 22.0%). Diabetic drugs were not associated with symptoms of constipation.
Diabetic neuropathy, defined as peripheral neuropathy of the lower limbs, was significantly associated with symptoms of constipation. Peripheral neuropathy of the lower limbs is not a direct risk factor for constipation but may be a useful criterion when assessing whether constipation is associated with DM.
糖尿病（DM）治疗方案的改变可能会影响消化道的功能。本研究旨在探讨与 DM 患者便秘症状相关的可能临床因素。
这是一项多中心研究。参与者为正在接受 1 型或 2 型 DM 治疗的连续日本患者。便秘通过胃肠道症状评分量表进行评估。下肢周围神经病变评估为是否存在周围神经病变。
在 419 名参与者中，258 名男性和 161 名女性（比例为 1.6:1），平均年龄为 63.6±12.5 岁。多变量分析显示，便秘症状与年龄（比值比 [OR] = 1.02，95%置信区间 [CI]：1.01-1.04，P = 0.032）、较低的心理成分综合评分（OR = 3.31，95%CI：1.69-6.48，P<0.001）、糖尿病视网膜病变（OR = 1.99，95%CI：1.14-3.45，P = 0.015）和糖尿病神经病变（OR = 1.86，95%CI：1.10-3.16，P = 0.021）显著相关。在下肢周围神经病变的患者中，无论是否存在其他并发症（糖尿病肾病和糖尿病视网膜病变），便秘症状的患病率是无周围神经病变患者的两倍（40.0-49.1% vs 22.0%）。糖尿病药物与便秘症状无关。
下肢周围神经病变定义为下肢周围神经病变，与便秘症状显著相关。下肢周围神经病变不是便秘的直接危险因素，但在评估便秘是否与 DM 相关时可能是有用的标准。
