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日本社区居住老年人肌肉减少症与便秘发病之间的关联

The Association between Sarcopenia and Constipation Onset in Community-dwelling Older Adults in Japan.

作者信息

Nakagawa Hiroaki, Takeshima Taro, Ozaka Akihiro, Sasaki Sho, Hamaguchi Sugihiro, Fukuhara Shunichi

机构信息

Center for Innovative Research for Communities and Clinical Excellence (CiRC²LE), Fukushima Medical University Hospital, Japan.

Department of General Internal Medicine, Fukushima Medical University, Japan.

出版信息

Intern Med. 2025 Jul 1;64(13):1965-1970. doi: 10.2169/internalmedicine.4391-24. Epub 2024 Dec 12.

Abstract

Objective Constipation is an important symptom in older adults. Sarcopenia is associated with constipation, but its directionality remains unclear. The present study assessed the association between sarcopenia and new-onset constipation. Methods This prospective cohort study assessed sarcopenia at baseline in 2019 using the the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire. Sarcopenia was defined as a SARC-F score of ≥4. Constipation was measured in 2019 and 2020 based on self-reported constipation or laxative use, using a self-administered questionnaire. Logistic regression was used to estimate the association between new-onset constipation in 2020 and sarcopenia status at the baseline. Patients Independent community-dwelling adults ≥75 years old in Sukagawa City, Fukushima, Japan. Results The analysis included 2,388 participants without constipation at baseline (mean age: 80.0±4.3 years old; 44.9% men), of whom 310 (13.0%) had sarcopenia at baseline. Overall, 262 participants (11.0%) developed constipation, including 57 of 310 (18.4%) with sarcopenia and 205 of 2,078 (9.9%) without sarcopenia. Participants with sarcopenia had a significantly higher risk of developing constipation than those without sarcopenia after adjusting for age, sex, lifestyle factors, and comorbidities (adjusted odds ratio, 1.98; 95% confidence interval, 1.40-2.81; p<0.001). The association between sarcopenia and new-onset constipation remained statistically significant at higher and lower SARC-F cutoff values. Conclusion Sarcopenia was associated with new-onset constipation. Sarcopenia is a risk factor for constipation in independent community-dwelling older adults ≥75 years old. Measures addressing sarcopenia may help prevent constipation in older adults.

摘要

目的 便秘是老年人的一个重要症状。肌肉减少症与便秘有关,但其方向性尚不清楚。本研究评估了肌肉减少症与新发便秘之间的关联。方法 这项前瞻性队列研究在2019年基线时使用力量、行走辅助、从椅子上起身、爬楼梯和跌倒(SARC-F)问卷评估肌肉减少症。肌肉减少症定义为SARC-F评分≥4分。在2019年和2020年根据自我报告的便秘或泻药使用情况,通过自行填写问卷来测量便秘。采用逻辑回归来估计2020年新发便秘与基线时肌肉减少症状态之间的关联。研究对象 日本福岛须贺川市年龄≥75岁的独立社区居住成年人。结果 分析纳入了2388名基线时无便秘的参与者(平均年龄:80.0±4.3岁;男性占44.9%),其中310人(13.0%)在基线时患有肌肉减少症。总体而言,262名参与者(11.0%)出现了便秘,包括310名中有57名(18.4%)患有肌肉减少症的参与者和2078名中205名(9.9%)没有肌肉减少症的参与者。在调整年龄、性别、生活方式因素和合并症后,患有肌肉减少症的参与者发生便秘的风险显著高于没有肌肉减少症的参与者(调整后的优势比为1.98;95%置信区间为1.40-2.81;p<0.001)。在较高和较低的SARC-F临界值时,肌肉减少症与新发便秘之间的关联在统计学上仍然显著。结论 肌肉减少症与新发便秘有关。肌肉减少症是≥75岁独立社区居住老年人便秘的一个危险因素。解决肌肉减少症的措施可能有助于预防老年人便秘。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9c1/12287569/978885850472/1349-7235-64-13-1965-g001.jpg

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