Yang Yuying, Rao Siyi, Zhuo Yongjie, Fang Yuan, Wan Jianxin, You Danyu
Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Front Nutr. 2025 Feb 17;12:1477148. doi: 10.3389/fnut.2025.1477148. eCollection 2025.
This study aimed to analyze the association between constipation and the urine albumin-to-creatinine ratio (ACR) using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2010.
In this cross-sectional study, a sample of 4,282 adults aged 20 and older was selected from the NHANES 2009-2010. Constipation was defined as having fewer than three bowel movements per week. The average of the two ACR measurements was used as the outcome variable. Logistic regression models (non-adjusted and multivariate adjusted models) were used to examine the relationship between constipation and ACR. Subgroup and interaction analyses related to gender, age, smoking, alcohol consumption, body mass index (BMI), hypertension, and diabetes were also conducted to assess the stability of the association between constipation and ACR.
In this study population of 4,282 individuals, 352 individuals with an ACR of 30 mg/g or higher were considered to have albuminuria. The prevalence of constipation was higher in the albuminuria group compared to the non-albuminuric group (6.4% vs. 3.5%, = 0.002). The unadjusted model (Model I) showed an increased risk of ACR associated with constipation (OR 1.81, 95% CI 1.13-2.91, = 0.014). After controlling for gender, age, race/ethnicity, marital status, and education level in Model II, the association between constipation and ACR remained significant (OR 2.20, 95% CI 1.34-3.60, = 0.002). Upon further adjustment for BMI, smoking status, alcohol consumption, diabetes, hypertension, arthritis, asthma, coronary heart disease, liver disease, cancer, blood urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA) and estimated glomerular filtration rate (eGFR) in Model III, the positive association between constipation and ACR was still significant (OR 1.88, 95% CI 1.09-3.23, = 0.023). Subgroup analyses, stratified by gender, age, smoking status, alcohol consumption, BMI, hypertension, and diabetes, showed no statistically significant interactions ( > 0.05).
In summary, this study found a positive association between constipation and urinary albumin excretion rate. The significant association between constipation and ACR highlights the need for clinicians to monitor urinary albumin levels in patients with constipation.
本研究旨在利用2009 - 2010年美国国家健康与营养检查调查（NHANES）的数据，分析便秘与尿白蛋白肌酐比值（ACR）之间的关联。
在这项横断面研究中，从2009 - 2010年NHANES中选取了4282名20岁及以上的成年人作为样本。便秘定义为每周排便少于三次。将两次ACR测量值的平均值用作结果变量。采用逻辑回归模型（未调整模型和多变量调整模型）来检验便秘与ACR之间的关系。还进行了与性别、年龄、吸烟、饮酒、体重指数（BMI）、高血压和糖尿病相关的亚组分析及交互作用分析，以评估便秘与ACR之间关联的稳定性。
在这4282名研究对象中，352名ACR为30 mg/g或更高的个体被认为患有蛋白尿。与无蛋白尿组相比，蛋白尿组的便秘患病率更高（6.4% 对3.5%，P = 0.002）。未调整模型（模型I）显示便秘与ACR升高风险相关（比值比[OR] 1.81，95%置信区间[CI] 1.13 - 2.91，P = 0.014）。在模型II中控制了性别、年龄、种族/民族、婚姻状况和教育水平后，便秘与ACR之间的关联仍然显著（OR 2.20，95% CI 1.34 - 3.60，P = 0.002）。在模型III中进一步调整了BMI、吸烟状况、饮酒、糖尿病、高血压、关节炎、哮喘、冠心病、肝病、癌症、血尿素氮（BUN）、血清肌酐（Scr）、尿酸（UA）和估计肾小球滤过率（eGFR）后，便秘与ACR之间的正相关仍然显著（OR 1.88，95% CI 1.09 - 3.23，P = 0.023）。按性别、年龄、吸烟状况、饮酒、BMI、高血压和糖尿病分层的亚组分析显示，无统计学显著的交互作用（P > 0.05）。
总之，本研究发现便秘与尿白蛋白排泄率之间存在正相关。便秘与ACR之间的显著关联凸显了临床医生对便秘患者监测尿白蛋白水平的必要性。
