Ye Sangyu, Huang Zichen, Zheng Lihua, Shi Yuying, Zhi Congcong, Liu Ningyuan, Cheng Yicheng
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Proctology Department, China-Japan Friendship Hospital, Beijing, China.
Front Surg. 2024 Jan 8;10:1329557. doi: 10.3389/fsurg.2023.1329557. eCollection 2023.
The epidemiological profile of anal fistula and anorectal abscess has not been well studied. Based on the results of a retrospective cross-sectional survey, we aimed to investigate the potential influential factors associated with anal fistula and anorectal abscess.
We conducted a retrospective analysis of outpatients who visited the proctology department at China-Japan Friendship Hospital between January 2017 and May 2022. A comprehensive questionnaire was designed to collect potential influential factors, and according to formal anorectal examination and the corresponding diagnostic criteria, all the participants were divided into patients with anal fistula or perianal abscess and healthy control group. Multiple logistic regression was used to identify factors in significant association with anal fistula and perianal abscess. Additionally, we combined restricted cubic spline regression to examine the dose-response relationship between factors and the risk of developing anal fistula or anorectal abscess.
The present study included 1,223 participants, including 1,018 males and 206 females, with 275 anal fistulas, 184 anorectal abscesses, and 765 healthy controls. We found no statistically significant differences between patients and controls in basic information and preoperative assessment of life factors, except for body mass index. It was indicated that people with overweight or obesity were more prone to anal fistula (OR = 1.35, 95% CI: 1.00-1.82, = 0.047; OR = 3.44, 95% CI: 2.26-5.26, < 0.001) or anorectal abscess (OR = 1.41, 95% CI: 1.00-1.99, = 0.05; OR : 2.24, 95% CI: 1.37-3.67, = 0.001) than normal-weight individuals. The dose-response research indicated the J-shaped trend between the ascending BMI levels and the higher risk of suffering from anal fistula and anorectal abscess.
Our findings indicate that overweight and obesity are risk factors for anal fistula and anorectal abscess, which plays a role in the prevention of anorectal diseases. This provides some theoretical basis for clinicians to provide health education to their patients.
肛瘘和肛管直肠周围脓肿的流行病学特征尚未得到充分研究。基于一项回顾性横断面调查结果，我们旨在探究与肛瘘和肛管直肠周围脓肿相关的潜在影响因素。
我们对2017年1月至2022年5月期间在中国-日本友好医院肛肠科就诊的门诊患者进行了回顾性分析。设计了一份综合问卷以收集潜在影响因素，并根据正规的肛肠检查及相应诊断标准，将所有参与者分为肛瘘或肛周脓肿患者组和健康对照组。采用多因素logistic回归分析确定与肛瘘和肛周脓肿显著相关的因素。此外，我们结合受限立方样条回归分析来研究各因素与发生肛瘘或肛管直肠周围脓肿风险之间的剂量反应关系。
本研究共纳入1223名参与者，其中男性1018名，女性206名，有275例肛瘘患者、184例肛管直肠周围脓肿患者以及765名健康对照者。除体重指数外，我们发现患者组与对照组在基本信息及术前生活因素评估方面无统计学显著差异。结果表明，超重或肥胖者比体重正常者更容易患肛瘘（比值比[OR]=1.35，95%置信区间[CI]：1.00-1.82，P=0.047；OR=3.44，95%CI：2.26-5.26，P<0.001）或肛管直肠周围脓肿（OR=1.41，95%CI：1.00-1.99，P=0.05；OR=2.24，95%CI：1.37-3.67，P=0.001）。剂量反应研究表明，体重指数升高水平与患肛瘘和肛管直肠周围脓肿的较高风险之间呈J形趋势。
我们的研究结果表明，超重和肥胖是肛瘘和肛管直肠周围脓肿的危险因素，这对预防肛肠疾病具有重要意义。这为临床医生对患者进行健康教育提供了一定的理论依据。
