Li Xianhua, Wen Haibin, Ke Jing, Zhao Dong
Center for Endocrine Metabolism and Immune Diseases, Beijing Lu He Hospital, Capital Medical University, Beijing, China.
Department of Nephrology, Jiang Bin Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
J Diabetes Investig. 2025 Mar;16(3):501-509. doi: 10.1111/jdi.14375. Epub 2024 Dec 24.
Constipation is a common complication in type 2 diabetes mellitus (T2DM), yet its impact on mortality remains unclear. This study aimed to investigate the association between constipation and all-cause mortality in patients with T2DM.
We conducted a retrospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010. Mortality outcomes were ascertained through linkage to National Death Index records until December 31, 2019. The association between constipation and all-cause mortality was assessed using weighted Cox proportional hazards regression models. Kaplan-Meier curves were then employed to visualize survival probabilities. Effect modification was explored through stratified analyses and interaction tests.
Of 1,339 participants with T2DM, 146 (10.90%) reported constipation. During a median follow-up of 10.75 years, 411 deaths occurred (57 in the constipation group, 354 in the non-constipation group). Fully adjusted weighted Cox regression analysis revealed that constipation was associated with increased all-cause mortality (HR 1.50, 95% CI 1.01-2.22, P = 0.04). Kaplan-Meier analysis demonstrated a significantly lower survival probability in patients with constipation (log-rank P < 0.05). Stratified analyses and interaction tests corroborated these findings across various subgroups.
Constipation is associated with elevated all-cause mortality risk in T2DM patients. These findings suggest that constipation management may be an important consideration in improving long-term outcomes for individuals with T2DM.
便秘是2型糖尿病（T2DM）的常见并发症，但其对死亡率的影响尚不清楚。本研究旨在调查T2DM患者便秘与全因死亡率之间的关联。
我们使用2005 - 2010年美国国家健康与营养检查调查（NHANES）的数据进行了一项回顾性队列研究。通过与国家死亡指数记录相链接确定死亡结局，截至2019年12月31日。使用加权Cox比例风险回归模型评估便秘与全因死亡率之间的关联。然后采用Kaplan-Meier曲线来直观显示生存概率。通过分层分析和交互检验探索效应修饰。
在1339名T2DM参与者中，146名（10.90%）报告有便秘。在中位随访10.75年期间，发生了411例死亡（便秘组57例，非便秘组354例）。完全调整后的加权Cox回归分析显示，便秘与全因死亡率增加相关（风险比1.50，95%置信区间1.01 - 2.22，P = 0.04）。Kaplan-Meier分析表明便秘患者的生存概率显著较低（对数秩P < 0.05）。分层分析和交互检验在各个亚组中证实了这些发现。
便秘与T2DM患者全因死亡风险升高相关。这些发现表明，便秘管理可能是改善T2DM患者长期结局的一个重要考虑因素。
