Physical Activity, BMI, and Risk of Fecal Incontinence in the Nurses' Health Study.
Physical Activity, BMI, and Risk of Fecal Incontinence in the Nurses' Health Study.
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DOI：
10.1038/s41424-018-0068-6
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发表时间：
2018-10-25
影响因子：
3.6
通讯作者：
Townsend MK
中科院分区：
文献类型：
--
作者：
Staller K;Song M;Grodstein F;Matthews CA;Whitehead WE;Kuo B;Chan AT;Townsend MK
在横断面研究中，较高的体重指数（BMI）和较低的体力活动与大便失禁（FI）患病率增加有关，但缺乏检验这些因素作用的前瞻性研究。我们试图确定 BMI 和/或体力活动是否与老年女性 FI 风险相关。我们在护士健康研究中前瞻性地研究了 BMI 与体力活动和 FI 风险之间的关联，调查对象为 2008 年 51,708 名没有发生 FI 的女性。我们将 FI 定义为在 2010 年或 2012 年报告的过去一年中每月≥1 次液体或固体 FI 发作。我们使用 Cox 比例风险模型来计算多变量调整风险比 (HR) 和 95% 置信区间 (CI) FI根据 身体活动和体重指数，调整潜在的混杂因素。在超过 175,000 人年的随访中，我们记录了 5954 起 FI 事件案例。与最低活动类别（<3 代谢当量任务 (MET) 小时/周）的女性相比，每周进行 3-8 MET 小时的女性 FI 的多变量调整 HR 为 0.86 (95% CI 0.80-0.93)，每周 9-17 MET 小时的女性为 0.78 (95% CI 0.72-0.84)，每周 9-17 MET 小时的 FI 为 0.76 (95% CI 0.72-0.84)。 CI 每周 18-26 MET 小时为 0.69–0.83)，每周 27 + MET 小时为 0.75 (95% CI 0.70–0.81) (Ptrend = <0.0001)。 BMI 与 FI 风险之间没有关联。较高水平的体力活动与老年女性发生 FI 事件的风险适度降低 (25%) 相关。这些结果支持随着年龄的增长，持续的体力活动对肛门直肠节制机制的神经肌肉健康的潜在作用。这些结果支持随着年龄的增长，持续的体力活动对肛门直肠节制机制的神经肌肉健康的潜在作用。
Higher body mass index (BMI) and low physical activity have been associated with increased prevalence of fecal incontinence (FI) in cross-sectional studies, but prospective studies examining the role of these factors are lacking. We sought to determine whether BMI and/or physical activity are associated with risk of FI among older women. We prospectively examined the association between BMI and physical activity and risk of FI in the Nurses’ Health Study among 51,708 women who were free of FI in 2008. We defined FI as at ≥1 liquid or solid FI episode/month during the past year reported in 2010 or 2012. We used Cox proportional hazards models to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for FI according to physical activity and BMI, adjusting for potential confounding factors. During more than 175,000 person-years of follow-up, we documented 5954 cases of incident FI. Compared with women in the lowest activity category (<3 metabolic equivalent of task (MET)-hrs/week), multivariable-adjusted HRs for FI were 0.86 (95% CI 0.80–0.93) for women doing 3–8 MET-hrs/week, 0.78 (95% CI 0.72–0.84) for 9–17 MET-hrs/week, 0.76 (95% CI 0.69–0.83) for 18–26 MET-hrs/week, and 0.75 (95% CI 0.70–0.81) for 27 + MET-hrs/week (Ptrend = <0.0001). There was no association between BMI and risk of FI. Higher levels of physical activity were associated with a modest reduction (25%) in risk of incident FI among older women. These results support a potential role of ongoing physical activity in the neuromuscular health of the anorectal continence mechanism with aging. These results support a potential role of ongoing physical activity in the neuromuscular health of the anorectal continence mechanism with aging.
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