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  • Title: Bowel Movement Frequency, Laxative Use, and Mortality From Coronary Heart Disease and Stroke Among Japanese Men and Women: The Japan Collaborative Cohort (JACC) Study.
    Author: Kubota Y, Iso H, Tamakoshi A.
    Journal: J Epidemiol; 2016 May 05; 26(5):242-8. PubMed ID: 26725286.
    Abstract:
    BACKGROUND: The associations of bowel movement frequency and laxative use with cardiovascular disease (CVD) are unclear. METHODS: A total of 72 014 subjects (29 668 men and 42 346 women) aged 40 to 79 years, without a history of CVD or cancer, completed a lifestyle questionnaire at baseline between 1988 and 1990 that included information on bowel movement frequency (daily, every 2-3 days, or once every 4 or more days) and laxative use (yes or no), and were followed-up until 2009. RESULTS: During the subjects' 1 165 569 person-years of follow-up, we documented 977 deaths from coronary heart disease (561 men and 416 women), 2024 from total stroke (1028 men and 996 women), 1127 from ischemic stroke (606 men and 521 women), and 828 from hemorrhagic stroke (388 men and 440 women). The prevalence of CVD risk factors, such as diabetes, stress, depression, and physical inactivity, was higher in laxative users and in those with a lower frequency of bowel movements. The multivariable HRs (95% confidence intervals [CIs]) of laxative users were as follows: 1.56 (95% CI, 1.21-2.03) for coronary heart disease and 1.37 (95% CI, 1.07-1.76) for ischemic stroke in men, and 1.27 (95% CI, 1.08-1.49) for total stroke, and 1.45 (95% CI, 1.17-1.79) for ischemic stroke in women. Similar results were observed even after the exclusion of deaths that occurred early in the follow-up period. A significant association between bowel movement frequency and mortality from CVD was not observed. CONCLUSIONS: Constipation could be a marker of exposure to CVD risk factors, and laxative use could be a risk factor for mortality from coronary heart disease and ischemic stroke. 背景：: 排便回数・下剤使用と循環器疾患との関連は明らかになっていない。 方法：: JACC studyで、循環器疾患およびがん既往のない40-79歳の男女72,014人（男性29,668人、女性42,346人）を1998-1990年から2009年まで追跡した。彼らはすべてベースライン時に排便回数（毎日、2-3日に1回、4日以上で１回）および下剤使用（はい、いいえ）に関する質問に回答している。 結果：: 1,165,596人年の追跡期間中、冠動脈疾患死亡997人（男性561人、女性416人）、全脳卒中死亡2,028人（男性1,028人、女性996人）、虚血性脳卒中1,127人（男性606人、女性521人）、および出血性脳卒中828人（男性388人、女性440人）であった。糖尿病、ストレス、うつ、および運動不足といった循環器疾患のリスクファクターの頻度は、下剤未使用者や排便回数の多い者に比べて、下剤使用者や排便回数の少ない者で低かった。下剤使用者の多変量調整ハザード（95%信頼区間）は、男性の冠動脈疾患死亡で1.56（1.21-2.03）、虚血性脳卒中で1.37（1.07–1.76）、女性の全脳卒中で1.27（1.08-1.49）、虚血性脳卒中で1.45（1.17-1.79）であった。早期死亡を除外した後も同様の結果が観察された。排便回数と循環器死亡との間には有意な関連は認めなかった。 結語：: 便秘は循環器疾患に危険因子曝露を示すマーカーである可能性がある。また、下剤使用は冠動脈疾患および虚血性脳卒中死亡の危険因子である可能性も示された。
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