【摘要】 目的 利用国家健康与营养调查(NHANES)数据集,探讨铜摄入与慢性便秘及腹泻风险之间的关联。方法提取NHANES数据库2005-2010年美国成年人数据。最终纳入12 417名,根据铜摄入量将受试者分为4个四分位组(Q1:<0.92 mg;Q2:0.92～1.21 mg;Q3:1.22～1.61 mg;Q4:>1.61 mg),分析4组人群基线数据特点。采用二元逻辑回归模型分析铜摄入量与便秘、腹泻之间的相关性,并使用限制性立方样条(RCS)图可视化剂量-反应关系。最后对总人群进行亚组分析,以探索特定变量的影响。结果 基线数据显示,随着铜摄入量的增加,慢性便秘的发生率逐渐下降从第一分位数的10.39%降至第四分位数的3.79%,但慢性腹泻的发生率未发生显著变化。在调整所有变量的逻辑回归模型中,铜摄入量与慢性便秘呈负相关(P<0.05)。二元逻辑回归结果显示镁摄入量与腹泻发生风呈负相关(P<0.05),锌摄入量与便秘和腹泻均无显著关联(P>0.05)。在调整镁和锌的摄入量后铜摄入量与便秘的关联依然显著,与最低摄入量Q1相比,Q2、Q3、Q4的OR值分别为0.98(0.96～1.00)、0.99(0.97～1.01)和0.98(0.95～1.00)。铜摄入量与慢性腹泻之间不存在显著关联(P>0.05)。RCS分析结果显示,铜摄入量与慢性便秘之间存在非线性相关性。亚组分析结果显示抑郁状态和BMI对铜摄入量与慢性便秘之间存在显著的交互作用(P=0.038、0.025),牛奶消费频次对铜摄入量与腹泻之间存在显著的交互作用(P=0.004)。结论 铜与便秘之间存在相关性,为铜元素在便秘发生中的潜在作用提供了新依据。更多还原

【Abstract】 Objective To investigate the association between copper intake and the risk of chronic constipation and diarrhea using data from the National Health and Nutrition Examination Survey(NHANES). Methods Data were extracted from three cycles(2005-2010) of the NHANES database, including U. S. adults. A total of 12 417 participants were included and divided into four quartiles based on copper intake: Q1(<0. 92 mg), Q2(0. 92-1. 21 mg), Q3(1. 22-1. 61 mg), and Q4(>1. 61 mg). Baseline characteristics were compared across the four groups. Binary logistic regression was used to examine the relationship between copper intake and constipation/diarrhea. Restricted cubic spline(RCS) plots were applied to visualize dose-response relationships. Subgroup analyses were performed to explore the influence of specific variables. Results Baseline data showed that the prevalence of chronic constipation gradually decreased from 10. 39% in Q1 to 3. 79% in Q4 with increasing copper intake, whereas no significant change was observed for chronic diarrhea. After adjusting for all covariates, logistic regression indicated a negative association between copper intake and chronic constipation(P<0. 05). Magnesium intake was negatively associated with diarrhea(P<0. 05), while zinc intake showed no significant association with either constipation or diarrhea(P>0. 05). After further adjustment for magnesium and zinc intake, copper intake remained significantly associated with constipation: compared with Q1, the OR values for Q2, Q3, and Q4 were 0. 98(0. 96-1. 00), 0. 99(0. 97-1. 01), and 0. 98(0. 95-1. 00), respectively. No significant association was found between copper intake and chronic diarrhea(P>0. 05). RCS analysis revealed a nonlinear relationship between copper intake and chronic constipation. Subgroup analyses indicated significant interactions between depression status and BMI with copper intake on constipation(P=0. 038 and P= 0. 025, respectively), and between milk consumption frequency and copper intake on diarrhea(P= 0. 004). Conclusion Copper intake is associated with constipation, providing new evidence for the potential role of copper in the pathogenesis of constipation.更多还原