切换至 "中华医学电子期刊资源库"

中华胃肠内镜电子杂志 ›› 2023, Vol. 10 ›› Issue (02) : 115 -120. doi: 10.3877/cma.j.issn.2095-7157.2023.02.007

论著

肥胖成人慢性腹泻患病率的系统评价和Meta分析
韩珂, 王祥耀, 茹楠, 牛晓彤, 向京元, 王妍, 高飞, 柴宁莉, 令狐恩强()   
  1. 100853 北京,解放军医学院;100853 北京,解放军总医院第一医学中心消化内科医学部
    100853 北京,解放军总医院第一医学中心消化内科医学部
  • 收稿日期:2023-03-13 出版日期:2023-05-15
  • 通信作者: 令狐恩强
  • 基金资助:
    国家重点研发计划(2020YFC2002705-2, 2022YFC2503601)

The prevalence of chronic diarrhea in obese adults: a systematic review with meta-analysis

Ke Han, Xiangyao Wang, Nan Ru, Xiaotong Niu, Jingyuan Xiang, Yan Wang, Fei Gao, Ningli Chai, Enqiang Linghu()   

  1. Medical School of Chinese PLA, Beijing 100853, China; Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
    Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Received:2023-03-13 Published:2023-05-15
  • Corresponding author: Enqiang Linghu
引用本文:

韩珂, 王祥耀, 茹楠, 牛晓彤, 向京元, 王妍, 高飞, 柴宁莉, 令狐恩强. 肥胖成人慢性腹泻患病率的系统评价和Meta分析[J/OL]. 中华胃肠内镜电子杂志, 2023, 10(02): 115-120.

Ke Han, Xiangyao Wang, Nan Ru, Xiaotong Niu, Jingyuan Xiang, Yan Wang, Fei Gao, Ningli Chai, Enqiang Linghu. The prevalence of chronic diarrhea in obese adults: a systematic review with meta-analysis[J/OL]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(02): 115-120.

目的

肥胖已成为全球严重的健康问题。多项研究表明,慢性腹泻在肥胖人群中较为常见。本研究对肥胖成人中慢性腹泻的患病率进行了系统评价和Meta分析。

方法

在PubMed、Embase和Web of Science文献数据库进行了系统检索,检索时间截止至2022年10月15日。本研究纳入了能够计算腹泻患病率的基于人群或肥胖患者的研究,由2名研究人员独立进行研究筛选,数据提取和质量评估。数据采用随机效应模型进行汇总。

结果

本研究共评估了8项研究,涉及19 701名受访者,其中11 820名为超重和肥胖个体。身体质量指数(body mass index, BMI)≥25 kg/m2的超重肥胖人群中,慢性腹泻的总体患病率为23.02%(95%CI: 17.47%, 28.57%)。肥胖组(BMI≥30 kg/m2)的腹泻患病率(23.79%,95%CI: 16.29%,31.29%)高于超重组(25 kg/m2≤BMI<30 kg/m2, 18.82%,95%CI: 13.02%,24.62%),但差异不具有统计学意义(P=0.30)。

结论

慢性腹泻在肥胖人群中相当常见,随着肥胖人数的增加,肥胖与慢性腹泻的共存值得更多关注。

Objective

Obesity has become a serious global health concern. A number of studies suggest that chronic diarrhea is frequent in obese people. We performed a systematic review and meta-analysis to assess the prevalence of chronic diarrhea in obese adults.

Methods

We systematically searched PubMed, Embase, and Web of Science for studies from inception through October 15, 2022.We included population-based or obese patient-based studies that could calculate the prevalence of diarrhea. Two researchers independently determined study eligibility, extracted data, and assessed quality.Data were pooled using a random effects model.

Results

Overall, 8 studies with 19, 701 respondents were assessed, including 11, 820 overweight and obese individuals.The pooled chronic diarrhea rate was 23.02% (95%CI: 17.47%, 28.57%) in people with a BMI≥ 25 kg/m2.The prevalence of diarrhea in the obese group (23.79%, 95%CI: 16.29%, 31.29%) was higher than that in the overweight group (18.82%, 95%CI: 13.02%, 24.62%), but it was not statistically significant (P=0.30).

Conclusions

Chronic diarrhea is quite common in obese populations.With the increasing number of obese people, and the coexistence of obesity and chronic diarrhea deserves extra attention.

图1 研究纳入和排除流程图
表1 入选研究基本信息和质量评估
图2 超重肥胖成人慢性腹泻患病率的森林图
图3 不同BMI亚组慢性腹泻患病率的森林图
图4 敏感性分析
[1]
González-Muniesa PMártinez-González MAHu FB,et al.Obesity [J].Nat Rev Dis Primers2017, 3: 17034.
[2]
Seidell JCHalberstadt J.The global burden of obesity and the challenges of prevention [J].Ann Nutr Metab201566(Suppl 2): 7-12.
[3]
Camilleri MMalhi HAcosta A.Gastrointestinal Complications of Obesity[J].Gastroenterology2017152(7): 1656-1670.
[4]
Eslick GD.Gastrointestinal symptoms and obesity:a meta-analysis [J].Obes Rev201213(5):469-479.
[5]
Bazerbachi FVargas EJAbu Dayyeh BK.Endoscopic Bariatric Therapy:A Guide to the Intragastric Balloon[J].Am J Gastroenterol, 2019, 114(9): 1421-1431.
[6]
令狐恩强.令狐氏肥胖腹泻综合征[J/CD].中华胃肠内镜电子杂志20218(4):145-146.
[7]
Linghu E.Obesity and chronic diarrhea:a new syndrome? [J].Chin Med J (Engl)2022135(15): 1806-1807.
[8]
Ballou SSingh PRangan V,et al.Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors:a cross-sectional analysis of the 2009-2010 National Health and Nutrition Examination Survey[J].Aliment Pharm Ther201950(9):1019-1024.
[9]
Delgado-Aros SLocke GR,3rdCamilleri M,et al.Obesity is associated with increased risk of gastrointestinal symptoms:a population-based study[J].Am J Gastroenterol200499(9):1801- 1806.
[10]
Singh PMitsuhashi SBallou S,et al.Demographic and Dietary Associations of Chronic Diarrhea in a Representative Sample of Adults in the United States[J].Am J Gastroenterol2018113(4): 593-600.
[11]
Levy RLLinde JAFeld KA,et al.The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants[J].Clin Gastroenterol Hepatol, 20053(10): 992-996.
[12]
Talley NJHowell SPoulton R.Obesity and chronic gastrointestinal tract symptoms in young adults:A birth cohort study[J].Am J Gastroenterol200499(9):1807-1814.
[13]
Talley NJQuan CJones MP,et al.Association of upper and lower gastrointestinal tract symptoms with body mass index in an Australian cohort[J].Neurogastroenterol Motil200416(4):413-419.
[14]
Alkhowaiter SAlotaibi RMAlwehaibi KK,et al.The Effect of Body Mass Index on the Prevalence of Gastrointestinal Symptoms Among a Saudi Population[J].Cureus202113(9): e17751.
[15]
Crowell MDCheskin LJMusial F.Prevalence of gastrointestinal symptoms in obese and normal weight binge eaters[J].Am J Gastroenterol199489(3): 387-391.
[16]
Moayyedi P.The epidemiology of obesity and gastrointestinal and other diseases:an overview[J].Dig Dis Sci200853(9): 2293-2299.
[17]
Page MJMcKenzie JEBossuyt PM,et al.The PRISMA 2020 statement:an updated guideline for reporting systematic reviews[J]. BMJ2021372: n71.
[18]
World Health Organization.Obesity:preventing and managing the global epidemic.Report of a WHO consultation[J].WHO Technical Report Series2000894(i-xii),1-253.
[19]
Loney PLChambers LWBennett KJ,et al.Critical appraisal of the health research literature:prevalence or incidence of a health problem[J].Chronic Dis Can199819(4):170-176.
[20]
Orwin RG.A Fail-SafeN for Effect Size in Meta-Analysis[J].J Educ Behav Stat19838(2):157-159.
[21]
Aro PRonkainen JTalley NJ,et al.Body mass index and chronic unexplained gastrointestinal symptoms:An adult endoscopic population based study[J].Gut200554(10):1377-1383.
[22]
Huseini M, Wood GC, Seiler J, et al. Gastrointestinal symptoms in morbid obesity[J].Front Med (Lausanne)20141(49):1-7.
[23]
Shin AXu HImperiale TF.Associations of chronic diarrhoea with non-Alcoholic fatty liver disease and obesity-related disorders among US adults[J].BMJ Open Gastroenter, 2019, 6(1): 1-9.
[24]
Schiller LRPardi DSSellin JH. Chronic Diarrhea:Diagnosis and Management[J].Clin Gastroenterol Hepatol201715(2):182-193. e183.
[25]
GBD 2016 Causes of Death Collaborators.Global,regional,and national age-sex specific mortality for 264 causes of death,1980- 2016:a systematic analysis for the Global Burden of Disease Study 2016[J].Lancet2017390(10100):1151 -1210.
[26]
汪颖,李泉,李沛霖,等.减重代谢手术前后规范化胃镜检查的分析研究[J/CD].中华胃肠内镜电子杂志2022, 9(2): 91-94.
[27]
Ciccocioppo RDe Giorgio R.Letter:diarrhoea in obese patients-a new nosographic entity?[J].Aliment Pharmacol Ther202051(3): 405.
[28]
Glasbrenner BPieramico OBrecht-Krauss D,et al.Gastric emptying of solids and liquids in obesity[J].Clin Investig1993, 71(7): 542-546.
[29]
Grybäck PNäslund EHellström PM,et al.Gastric emptying of solids in humans: improved evaluation by Kaplan-Meier plots, with special reference to obesity and gender[J].Eur J Nucl Med1996, 23(12):1562-1567.
[30]
Delgado-Aros SCamilleri MGarcia MA,et al.High body mass alters colonic sensory-motor function and transit in humans[J].Am J Physiol Gastrointest Liver Physiol2008295(2):G382-388.
[31]
Cani PDBibiloni RKnauf C,et al.Changes in gut microbiota control metabolic endotoxemia-induced inflammation in high-fat diet-induced obesity and diabetes in mice[J].Diabetes200857(6): 1470-1481.
[32]
Teixeira TFSouza NCChiarello PG,et al.Intestinal permeability parameters in obese patients are correlated with metabolic syndrome risk factors[J].Clin Nutr201231(5):735-740.
[33]
Teixeira TFCollado MCFerreira CL,et al.Potential mechanisms for the emerging link between obesity and increased intestinal permeability[J].Nutr Res201232(9): 637-647.
[34]
Maruvada PLeone VKaplan LM,et al.The Human Microbiome and Obesity:Moving beyond Associations[J].Cell Host Microbe2017, 22(5): 589-599.
[35]
Liu CSLiang XWei XH,et al.Gegen Qinlian Decoction Treats Diarrhea in Piglets by Modulating Gut Microbiota and Short-Chain Fatty Acids[J].Front Microbiol201910(825):1-11.
[36]
Camilleri MVijayvargiya P.The Role of Bile Acids in Chronic Diarrhea[J].Am J Gastroenterol2020115(10):1596-1603.
[37]
Sadik RAbrahamsson HUng KA,et al.Accelerated regional bowel transit and overweight shown in idiopathic bile acid malabsorption [J].Am J Gastroenterol200499(4):711-718.
[38]
Poullis AFoster RShetty A,et al.Bowel inflammation as measured by fecal calprotectin:a link between lifestyle factors and colorectal cancer risk[J].Cancer Epidemiol Biomarkers Prev200413(2):279- 284.
[1] 蚁淳, 袁冬生, 熊学军. 系统免疫炎症指数与骨密度降低和骨质疏松的关联[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 609-617.
[2] 向韵, 卢游, 杨凡. 全氟及多氟烷基化合物暴露与儿童肥胖症相关性研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 569-574.
[3] 赵丽霞, 王春霞, 陈一锋, 胡东平, 张维胜, 王涛, 张洪来. 内脏型肥胖对腹腔镜直肠癌根治术后早期并发症的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 35-39.
[4] 孟令凯, 李大勇, 王宁, 王桂明, 张炳南, 李若彤, 潘立峰. 袖状胃切除术对肥胖伴2型糖尿病大鼠的作用及机制研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 638-642.
[5] 李猛, 姜腊, 董磊, 吴情, 贾犇黎. 腹腔镜胃袖状切除术治疗肥胖合并2型糖尿病及脂肪胰的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 554-557.
[6] 玉素江·图荪托合提, 韩琦, 麦麦提艾力·麦麦提明, 黄旭东, 王浩, 克力木·阿不都热依木, 艾克拜尔·艾力. 腹腔镜袖状胃切除或联合食管裂孔疝修补术对肥胖症合并胃食管反流病的中期疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 501-506.
[7] 刘见, 杨晓波, 何均健, 等. 应用电钩三孔法腹腔镜袖状胃切除术[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(06): 363-364.
[8] 马振威, 宋润夫, 王兵. ERCP胆道内支架与骑跨十二指肠乳头支架置入治疗不可切除肝门部胆管癌疗效的Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 807-812.
[9] 曹文钰, 郭鹏, 李锦平. 微创手术及非手术方式治疗慢性硬膜下血肿的研究进展[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 304-309.
[10] 王芳, 刘达, 左智炜, 盛金平, 陈庭进, 蒋锐. 定量CT与双能X线骨密度仪对骨质疏松诊断效能比较的Meta分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 363-371.
[11] 韩俊岭, 王刚, 马厉英, 连颖, 徐慧. 维生素D 联合匹维溴铵治疗腹泻型肠易激综合征患者疗效及对肠道屏障功能指标的影响研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 560-564.
[12] 谢浩文, 丁建英, 刘小霞, 冯毅, 姚婧. 椎旁神经阻滞对微创胃切除肥胖患者术中血流、术后应激及康复质量的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 569-573.
[13] 闫维, 张二明, 张克, 安欣华, 向平超. 北京市石景山区40岁及以上居民早期慢性阻塞性肺疾病异质性及影响因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 533-540.
[14] 周倩妹, 王宪娥, 徐筱, 老慧琳, 赵欣悦, 胡菁颖. 多元化系统护理对老年人群牙周健康指标影响的系统评价[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 500-506.
[15] 王星, 陈园, 热孜万古丽·乌斯曼, 郭艳英. T2DM、Obesity、NASH、PCOS共同致病因素相关的分子机制[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 481-490.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?