Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Arab J Gastroenterol. 2023 Nov;24(4):204-210. doi: 10.1016/j.ajg.2023.05.003. Epub 2023 Jul 31.
Childhood functional constipation (FC) is gradually becoming an emerging public health problem. This study aimed to develop a personalized nomogram for the prediction of incident FC among Chinese children, and the diagnosis of FC was based on the Rome IV criteria.
This cross-sectional study was conducted from Nov. 2020 to Jan. 2021 among children residing in Anhui province, China. An electronic questionnaire regarding the general demographic and clinical characteristics of all children was completed by their primary caregivers. The multivariate logistic regression analysis was applied to identify risk factors for FC. Moreover, a nomogram was constructed for FC based on the risk factors identified from the multivariate analysis.
In this study, a total of 901 electronic questionnaires were collected, of which 832 (92.3%) questionnaires were properly completed and included in the final analysis. The prevalence of FC among Chinese children was 11.3% based on the Rome IV criteria. After controlling for potential confounding factors, the multivariate logistic regression analysis showed that inadequate sleep, picky eating, and positive family history of FC were identified as key risk factors of FC. The area under the receiver operating characteristic curve of the nomogram was 0.694 (95 %CI: 0.6412-0.7459). Further, a calibration curve drawn illustrated that the predicted probabilities reasonably approximately the actual prevalence of FC in this population.
Inadequate sleep, picky eating, and positive family history of FC were identified as risk factors of FC. An easy-to-use nomogram was constructed based on these three significant factors. Besides, this nomogram was validated to have acceptable discrimination and calibration capabilities. Hence, this nomogram may enable clinical professionals to predict the risk of FC among Chinese children and further provide optimized disease prevention and intervention for this population.
儿童功能性便秘（FC）逐渐成为一个新兴的公共卫生问题。本研究旨在为中国儿童制定预测 FC 发病的个性化列线图，FC 的诊断依据为罗马 IV 标准。
这是一项 2020 年 11 月至 2021 年 1 月在中国安徽省进行的横断面研究。主要照顾者通过电子问卷完成了所有儿童的一般人口统计学和临床特征的调查。采用多变量逻辑回归分析确定 FC 的危险因素。此外，基于多变量分析中确定的危险因素，构建了 FC 的列线图。
本研究共收集了 901 份电子问卷，其中 832 份（92.3%）问卷填写完整并纳入最终分析。根据罗马 IV 标准，中国儿童 FC 的患病率为 11.3%。在控制潜在混杂因素后，多变量逻辑回归分析显示，睡眠不足、挑食和 FC 阳性家族史是 FC 的关键危险因素。列线图的受试者工作特征曲线下面积为 0.694（95%CI：0.6412-0.7459）。进一步绘制校准曲线表明，该列线图预测的概率与该人群中 FC 的实际患病率相当接近。
睡眠不足、挑食和 FC 阳性家族史是 FC 的危险因素。基于这三个重要因素构建了一个易于使用的列线图。此外，该列线图的验证结果表明其具有可接受的判别和校准能力。因此，该列线图可帮助临床医生预测中国儿童 FC 的发病风险，并进一步为该人群提供优化的疾病预防和干预措施。
