Association Between Regular Laxative Use and Incident Dementia in UK Biobank Participants.
Association Between Regular Laxative Use and Incident Dementia in UK Biobank Participants.
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DOI：
10.1212/wnl.0000000000207081
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发表时间：
2023-04-18
期刊：
影响因子：
9.9
通讯作者：
中科院分区：
文献类型：
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作者：
使用非处方泻药在一般人群中很常见。微生物组-肠-脑轴假说表明，使用泻药可能与痴呆症有关。我们的目的是研究英国生物银行参与者定期使用泻药与痴呆症发病率之间的关系。这项前瞻性队列研究基于年龄在40-69岁之间的英国生物银行参与者，他们没有痴呆症病史。定期使用泻药定义为基线时（2006-2010年）最后4周内一周大部分时间自我报告使用泻药。结果是全因痴呆，阿尔茨海默病（AD）和血管性痴呆（VD），从相关的住院或死亡登记中确定（截至2019年）。在多变量考克斯回归分析中调整了社会人口学特征、生活方式因素、医疗条件、家族史和定期用药。在基线时平均年龄为56.5（SD 8.1）岁的502，229名参与者中，273，251名（54.4%）为女性，18，235名（3.6%）报告定期使用泻药。在平均9.8年的随访中，218名（1.3%）经常使用泻药的参与者和1，969名（0.4%）没有经常使用的参与者发展为全因痴呆症。多变量分析显示，经常使用泻药与全因痴呆（风险比[HR] 1.51; 95% CI 1.30-1.75）和VD（HR 1.65; 95% CI 1.21-2.27）的风险增加相关，未观察到与AD（HR 1.05; 95% CI 0.79-1.40）的显著相关性。全因性痴呆和VD的风险均随着定期使用泻药类型的数量而增加（p趋势分别为0.001和0.04）。在明确报告仅使用1种泻药的参与者（n = 5，800）中，仅使用渗透性泻药的参与者显示出全因痴呆（HR 1.64; 95% CI 1.20-2.24）和VD（HR 1.97; 95% CI 1.04-3.75）的统计学显著性较高风险。这些结果在各种亚组和敏感性分析中保持稳健。经常使用泻药与全因痴呆的风险较高相关，特别是在使用多种泻药类型或渗透性泻药的人中。
The use of over-the-counter laxatives is common in the general population. The microbiome-gut-brain axis hypothesis suggests that the use of laxatives could be associated with dementia. We aimed to examine the association between the regular use of laxatives and the incidence of dementia in UK Biobank participants. This prospective cohort study was based on UK Biobank participants aged 40–69 years without a history of dementia. Regular use of laxatives was defined as self-reported use in most days of the week for the last 4 weeks at baseline (2006–2010). The outcomes were all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD), identified from linked hospital admissions or death registers (up to 2019). Sociodemographic characteristics, lifestyle factors, medical conditions, family history, and regular medication use were adjusted for in the multivariable Cox regression analyses. Among the 502,229 participants with a mean age of 56.5 (SD 8.1) years at baseline, 273,251 (54.4%) were female, and 18,235 (3.6%) reported regular use of laxatives. Over a mean follow-up of 9.8 years, 218 (1.3%) participants with regular use of laxatives and 1,969 (0.4%) with no regular use developed all-cause dementia. Multivariable analyses showed that regular use of laxatives was associated with increased risk of all-cause dementia (hazard ratio [HR] 1.51; 95% CI 1.30–1.75) and VD (HR 1.65; 95% CI 1.21–2.27), with no significant association observed for AD (HR 1.05; 95% CI 0.79–1.40). The risk of both all-cause dementia and VD increased with the number of regularly used laxative types (p trend 0.001 and 0.04, respectively). Among the participants who clearly reported that they were using just 1 type of laxative (n = 5,800), only those using osmotic laxatives showed a statistically significantly higher risk of all-cause dementia (HR 1.64; 95% CI 1.20–2.24) and VD (HR 1.97; 95% CI 1.04–3.75). These results remained robust in various subgroup and sensitivity analyses. Regular use of laxatives was associated with a higher risk of all-cause dementia, particularly in those who used multiple laxative types or osmotic laxative.
影响因子：
4.1
作者：
Haring B;Pettinger M;Bea JW;Wactawski-Wende J;Carnahan RM;Ockene JK;Wyler von Ballmoos M;Wallace RB;Wassertheil-Smoller S
通讯作者：
Wassertheil-Smoller S