Association between constipation and coronary heart disease in adult Americans: evidence from NHANES 2005–2010
美国成年人便秘与冠心病之间的关联:来自 NHANES 2005-2010 的证据
Figure 1. Flow diagram of the sample selection from the National Health and Nutrition Examination Survey (NHANES) 2005–2010.
图 1.2005-2010 年国家健康和营养检查调查 (NHANES) 的样本选择流程图。
Table 1. Characteristics of the participants in the CHD and non-CHD groups. | ||||
Variables | Total (n = 12794) | Non-CHD a | CHD | P value |
0 (n = 11858) | 1 (n = 936) | |||
Gender, n (%) | < 0.001 | |||
Male | 6476 (50.6) | 5861 (49.4) | 615 (65.7) |
|
Female | 6318 (49.4) | 5997 (50.6) | 321 (34.3) |
|
Age, years Mean ± SD | 49.6 ± 17.7 | 48.3 ± 17.4 | 66.6 ± 12.8 | < 0.001 |
BMI, n (%) | < 0.001 | |||
Under/normal weight (< 25.0) | 3672 (28.7) | 3480 (29.3) | 192 (20.5) |
|
Overweight (25.0–29.9) | 4367 (34.1) | 4046 (34.1) | 321 (34.3) |
|
Obese (≥30.0) | 4755 (37.2) | 4332 (36.5) | 423 (45.2) |
|
Race/Ethnicity, n (%) b | < 0.001 | |||
Non-Hispanic White | 6486 (50.7) | 5885 (49.6) | 601 (64.2) |
|
Non-Hispanic Black | 2557 (20.0) | 2399 (20.2) | 158 (16.9) |
|
Mexican American | 2244 (17.5) | 2144 (18.1) | 100 (10.7) |
|
Other race c | 1507 (11.8) | 1430 (12.1) | 77 (8.2) |
|
Marital Status, n (%) | < 0.001 | |||
Married or living with partner | 7821 (61.2) | 7265 (61.3) | 556 (59.4) |
|
Windowed, divorce or separated | 2889 (22.6) | 2557 (21.6) | 332 (35.5) |
|
Never married | 2077 (16.2) | 2029 (17.1) | 48 (5.1) |
|
Education, n (%) | < 0.001 | |||
≤high school | 6548 (51.2) | 5973 (50.4) | 575 (61.4) |
|
>high school | 6246 (48.8) | 5885 (49.6) | 361 (38.6) |
|
Family income PIR, n (%) | < 0.001 | |||
<1.3 | 3720 (29.1) | 3409 (28.7) | 311 (33.2) |
|
1.3~3.4 | 4929 (38.5) | 4529 (38.2) | 400 (42.7) |
|
≥3.5 | 4145 (32.4) | 3920 (33.1) | 225 (24) |
|
Smoke, n (%) | < 0.001 | |||
Never | 6643 (51.9) | 6316 (53.3) | 327 (34.9) |
|
Former | 3275 (25.6) | 2868 (24.2) | 407 (43.5) |
|
Current | 2876 (22.5) | 2674 (22.6) | 202 (21.6) |
|
Alcohol, n (%) | 0.05 | |||
No | 3556 (27.8) | 3270 (27.6) | 286 (30.6) |
|
Yes | 9238 (72.2) | 8588 (72.4) | 650 (69.4) |
|
Diabetes, n (%) | < 0.001 | |||
No | 11343 (88.7) | 10690 (90.2) | 653 (69.8) |
|
Yes | 1451 (11.3) | 1168 (9.8) | 283 (30.2) |
|
Hypertension, n (%) | < 0.001 | |||
No | 8313 (65.0) | 8049 (67.9) | 264 (28.2) |
|
Yes | 4481 (35.0) | 3809 (32.1) | 672 (71.8) |
|
Dietary protein intake, n (%) | < 0.001 | |||
Lowest quartile | 3199 (25.0) | 2880 (24.3) | 319 (34.1) |
|
Middle lower quartile | 3198 (25.0) | 2927 (24.7) | 271 (29) |
|
Middle upper quartile | 3198 (25.0) | 3005 (25.3) | 193 (20.6) |
|
Highest quartile | 3199 (25.0) | 3046 (25.7) | 153 (16.3) |
|
Carbohydrate intake, n (%) | < 0.001 | |||
Lowest quartile | 3199 (25.0) | 2890 (24.4) | 309 (33) |
|
Middle lower quartile | 3198 (25.0) | 2934 (24.7) | 264 (28.2) |
|
Middle upper quartile | 3198 (25.0) | 2977 (25.1) | 221 (23.6) |
|
Highest quartile | 3199 (25.0) | 3057 (25.8) | 142 (15.2) |
|
Sugar intake, n (%) | < 0.001 | |||
Lowest quartile | 3198 (25.0) | 2890 (24.4) | 308 (32.9) |
|
Middle lower quartile | 3199 (25.0) | 2948 (24.9) | 251 (26.8) |
|
Middle upper quartile | 3198 (25.0) | 2990 (25.2) | 208 (22.2) |
|
Highest quartile | 3199 (25.0) | 3030 (25.6) | 169 (18.1) |
|
Dietary Fiber intake, n (%) | 0.017 | |||
Lowest quartile | 3187 (24.9) | 2924 (24.7) | 263 (28.1) |
|
Middle lower quartile | 3182 (24.9) | 2945 (24.8) | 237 (25.3) |
|
Middle upper quartile | 3214 (25.1) | 2977 (25.1) | 237 (25.3) |
|
Highest quartile | 3211 (25.1) | 3012 (25.4) | 199 (21.3) |
|
Total fat intake, n (%) | < 0.001 | |||
Lowest quartile | 3199 (25.0) | 2890 (24.4) | 309 (33) |
|
Middle lower quartile | 3198 (25.0) | 2928 (24.7) | 270 (28.8) |
|
Middle upper quartile | 3198 (25.0) | 2995 (25.3) | 203 (21.7) |
|
Highest quartile | 3199 (25.0) | 3045 (25.7) | 154 (16.5) |
|
Moisture intake, n (%) | < 0.001 | |||
Lowest quartile | 3199 (25.0) | 2912 (24.6) | 287 (30.7) |
|
Middle lower quartile | 3198 (25.0) | 2946 (24.8) | 252 (26.9) |
|
Middle upper quartile | 3198 (25.0) | 2971 (25.1) | 227 (24.3) |
|
Highest quartile | 3199 (25.0) | 3029 (25.5) | 170 (18.2) |
|
Constipation, n (%) | 0.022 | |||
No | 12360 (96.6) | 11468 (96.7) | 892 (95.3) |
|
Yes | 434 ( 3.4) | 390 (3.3) | 44 (4.7) |
|
BMI, body mass index; CHD, coronary heart disease; PIR, poverty income ratio; a Includes congestive heart failure, coronary heart disease, angina, heart attack. b Race and ethnicity were self-reported. c Includes multiracial participants and NHANES does not provide a detailed list of all races and ethnicities.
BMI,体重指数;冠心病,冠心病;PIR: 贫困收入比; a 包括充血性心力衰竭、冠心病、心绞痛、心脏病发作。 b 种族和民族是自我报告的。 c 包括多种族参与者,NHANES 没有提供所有种族和民族的详细列表。
Table 2. Univariate regression analysis. | ||
Variable | OR (95%CI) | P value |
Gender: Female vs Male | 0.51 (0.44~0.59) | <0.001 |
Age | 1.07 (1.07~1.08) | <0.001 |
BMI:ref.= Under/normal weight (< 25.0) | ||
Overweight (25.0–29.9) | 1.44 (1.2~1.73) | <0.001 |
Obese (≥30.0) | 1.77 (1.48~2.11) | <0.001 |
Race/Ethnicity: ref.= Non-Hispanic White | ||
Non-Hispanic Black | 0.64 (0.54~0.77) | <0.001 |
Mexican American | 0.46 (0.37~0.57) | <0.001 |
Other race | 0.53 (0.41~0.67) | <0.001 |
Marital Status: ref.= Married or living with partner | ||
Windowed, divorced or seperated | 1.7 (1.47~1.96) | <0.001 |
Never married | 0.31 (0.23~0.42) | <0.001 |
Education:>high school vs. ≤high school | 0.64 (0.56~0.73) | <0.001 |
Family income PIR: ref.= (<1.3) | ||
1.3~3.4 | 0.97 (0.83~1.13) | 0.681 |
≥3.5 | 0.63 (0.53~0.75) | <0.001 |
Smoke status: ref.=Never | ||
Former | 2.74 (2.35~3.19) | <0.001 |
Current | 1.46 (1.22~1.75) | <0.001 |
Alcohol: Yes vs. No | 0.87 (0.75~1) | 0.05 |
Diabetes: Yes vs. No | 3.97 (3.41~4.62) | <0.001 |
Hypertension: Yes vs. No | 5.38 (4.64~6.23) | <0.001 |
Dietary protein intake: ref.= Lowest quartile | ||
Middle lower quartile | 0.84 (0.71~0.99) | 0.039 |
Middle upper quartile | 0.58 (0.48~0.7) | <0.001 |
Highest quartile | 0.45 (0.37~0.55) | <0.001 |
Carbohydrate intake: ref.= Lowest quartile | ||
Middle lower quartile | 0.84 (0.71~1) | 0.049 |
Middle upper quartile | 0.69 (0.58~0.83) | <0.001 |
Highest quartile | 0.43 (0.35~0.53) | <0.001 |
Sugar intake: ref.= Lowest quartile | ||
Middle lower quartile | 0.8 (0.67~0.95) | 0.012 |
Middle upper quartile | 0.65 (0.54~0.78) | <0.001 |
Highest quartile | 0.52 (0.43~0.64) | <0.001 |
Dietary Fiber intake: ref.= Lowest quartile | ||
Middle lower quartile | 0.89 (0.75~1.07) | 0.233 |
Middle upper quartile | 0.89 (0.74~1.06) | 0.191 |
Highest quartile | 0.73 (0.61~0.89) | 0.002 |
Total fat intake: ref.= Lowest quartile | ||
Middle lower quartile | 0.86 (0.73~1.02) | 0.09 |
Middle upper quartile | 0.63 (0.53~0.76) | <0.001 |
Highest quartile | 0.47 (0.39~0.58) | <0.001 |
Moisture intake: ref.= Lowest quartile | ||
Middle lower quartile | 0.87 (0.73~1.04) | 0.116 |
Middle upper quartile | 0.78 (0.65~0.93) | 0.006 |
Highest quartile | 0.57 (0.47~0.69) | <0.001 |
Constipation: Yes vs. No | 1.45 (1.05~2) | 0.022 |
BMI, body mass index; CHD, coronary heart disease; PIR, poverty income ratio;
BMI,体重指数;冠心病,冠心病;PIR: 贫困收入比;
Table 3. Multivariate regression analysis of the association between constipation and coronary heart disease.
表 3.便秘与冠心病关联的多因素回归分析。
|
a Model Ⅰ: no adjusted.
a 型号 I.:未调整。
b Model Ⅱ: adjusted for age + gender.
b 模型II.:根据年龄+性别进行调整。
c Model Ⅲ: Model Ⅱ+ race/ethnicity + marital status+ education level+ poverty income ratio + body mass index + smoke status + alcohol consumption.
c 模型III.:模型II.+种族/民族+婚姻状况+教育程度+贫困收入比+体重指数+吸烟状况+饮酒量。
d Model Ⅳ: Model Ⅲ + diabetes + hypertension.
d 模型IV.:模型III.+糖尿病+高血压。
e Model Ⅴ: Model IV + protein+ carbohydrate + sugar + dietary fiber + total fat + moisture.
Figure 2.
Association between constipation and coronary heart disease in different subgroups. Adjusted for age, sex, race/ethnicity, marital status, education level, body mass index, family poverty income ratio, smoking status, alcohol intake, diabetes, hypertension, dietary fiber intake, moisture intake, total fat intake, carbohydrates intake, and protein intake.
不同亚组便秘与冠心病之间的关联。根据年龄、性别、种族/民族、婚姻状况、教育水平、体重指数、家庭贫困收入比、吸烟状况、酒精摄入量、糖尿病、高血压、膳食纤维摄入量、水分摄入量、总脂肪摄入量、碳水化合物摄入量和蛋白质摄入量进行调整。