Graduate School of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.
Department of General Surgery, Children's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40206. doi: 10.1097/MD.0000000000040206.
Traditional observational studies have reported a positive association between constipation and the risk of colorectal cancer (CRC). However, evidence from other approaches to pursue the causal relationship between constipation and CRC is scarce. In the study, 2-sample Mendelian randomization analysis was conducted to investigate the potential causal relationship between constipation and CRC. Analysis of the results showed that there was no causal association between constipation and CRC, either in European populations (CRC: odds ratio [OR] = 1.00, 95% confidence interval [CI] = 0.99-1.00, P = .49; rectal cancer: OR = 0.99, 95% CI = 0.99-1.00, P = .79) or in Asian populations (CRC: OR = 1.00, 95% CI = 0.99-1.01, P = .30). Also there was no inverse causal association between CRC and constipation, either in European populations (CRC: OR = 0.10, 95% CI = 2.76E-03-3.45, P = .20; rectal cancer: OR = 0.05, 95% CI = 9.14E-07-2.64E + 03, P = .59) or in Asian population (CRC: OR = 1.18, 95% CI = 0.92-1.52, P = .20), there was no horizontal diversity in the instrumental variables in the Mendelian randomization analyses of the present study (all F statistics >10), and no heterogeneity was found in the regression analyses. The findings from bidirectional 2-sample Mendelian randomization analyses indicate that there is no evidence of a bidirectional causal association between constipation and CRC. However, further investigation is warranted through additional clinical studies and trials to thoroughly explore the association between these 2 factors.
传统的观察性研究报告称，便秘与结直肠癌（CRC）的风险呈正相关。然而，其他方法来探讨便秘和 CRC 之间因果关系的证据很少。在这项研究中，进行了两样本孟德尔随机化分析，以调查便秘和 CRC 之间潜在的因果关系。结果分析表明，便秘与 CRC 之间没有因果关系，无论是在欧洲人群中（CRC：比值比[OR] = 1.00，95%置信区间[CI] = 0.99-1.00，P =.49；直肠肿瘤：OR = 0.99，95% CI = 0.99-1.00，P =.79）还是在亚洲人群中（CRC：OR = 1.00，95% CI = 0.99-1.01，P =.30）。同样，CRC 与便秘之间也没有反向因果关系，无论是在欧洲人群中（CRC：OR = 0.10，95% CI = 2.76E-03-3.45，P =.20；直肠肿瘤：OR = 0.05，95% CI = 9.14E-07-2.64E + 03，P =.59）还是在亚洲人群中（CRC：OR = 1.18，95% CI = 0.92-1.52，P =.20），本研究的孟德尔随机化分析中工具变量没有水平差异（所有 F 统计量>10），回归分析中也没有发现异质性。双向两样本孟德尔随机化分析的结果表明，便秘和 CRC 之间没有双向因果关系的证据。然而，需要通过额外的临床研究和试验来进一步探讨这两个因素之间的关系。
