Association of abnormal bowel health with major chronic diseases and risk of mortality

Peng, Yu; Liu, Fubin; Qiao, Yating; Wang, Peng; Ma, Bing; Liu, Limin; Si, Changyu; Wang, Xixuan; Zhang, Ming; Song, Fang

doi:10.1016/j.annepidem.2022.09.002

Cited by 18 publications

(6 citation statements)

References 35 publications

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“…The remaining proteins associated with aberrant BMFs were related to inflammation and undesirable immune responses, organ damage, and cancer ( Fig. 7 ) [71,72].…”

Section: Discussionmentioning

confidence: 99%

Generally-healthy individuals with aberrant bowel movement frequencies show enrichment for microbially-derived blood metabolites associated with reduced kidney function

Johnson

Diener

Levine

et al. 2023

Preprint

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ObiectiveBowel movement frequency (BMF) variation has been linked to changes in the composition of the human gut microbiome and to many chronic conditions, like metabolic disorders, neurodegenerative diseases, chronic kidney disease (CKD), and other intestinal pathologies like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Slow intestinal transit times (constipation) are thought to lead to compromised intestinal barrier integrity and a switch from saccharolytic to proteolytic fermentation within the microbiota, giving rise to microbially-derived toxins that may make their way into circulation and cause damage to organ systems. However, these phenomena have not been characterized in generally-healthy populations, and the connections between microbial metabolism and the early-stage development and progression of chronic disease remain underexplored.DesignHere, we examine the phenotypic impact of BMF variation across a cohort of over 2,000 generally-healthy, community dwelling adults with detailed clinical, lifestyle, and multi-omic data.ResultsWe show significant differences in key blood plasma metabolites, proteins, chemistries, gut bacterial genera, and lifestyle factors across BMF groups that have been linked, in particular, to inflammation and CKD severity and progression.DiscussionIn addition to dissecting BMF-related heterogeneity in blood metabolites, proteins, and the gut microbiome, we identify self-reported diet, lifestyle, and psychological factors associated with BMF variation, which suggest several potential strategies for mitigating constipation and diarrhea. Overall, this work highlights the potential for managing BMF to prevent disease.What is already known about this topicConstipation and diarrhea are linked to several chronic diseases, like IBD, CKD, and neurodegenerative disorders. Chronic constipation, in particular, is associated with the increased production of microbially-derived uremic toxins in the gut due to an ecosystem-wide switch from fiber fermentation to protein fermentation. A build-up of these gut-derived toxins in blood, like p-cresol, has been associated with CKD disease progression and severity.What this study addsWhile prior work has demonstrated associations between microbially-derived uremic toxins, constipation, and CKD severity/progression, here we show similar signatures in a generally-healthy cohort. Overall, we map out the molecular phenotypic effects of aberrant BMFs across individuals without any apparent disease, and show how these effects precede, and may contribute to, the development of chronic disease. We find that certain lifestyle and dietary patterns, like higher levels of exercise, reduced anxiety levels, a more plant-based diet, and drinking more water, are associated with a more optimal BMF range.How this study might affect research, policy, or practiceOverall, we suggest that even mild levels of chronic constipation may cause damage to organ systems over time and ultimately give rise to chronic diseases, like CKD or neurodegeneration. These findings pave the way for future research into early interventions for individuals at risk of developing chronic diseases related to BMF abnormalities. Managing BMF abnormalities prior to disease development may be an important disease prevention strategy, but this will require further evidence through longitudinal human intervention trials.

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“…The remaining proteins associated with aberrant BMFs were related to inflammation and undesirable immune responses, organ damage, and cancer ( Fig. 7 ) [71,72].…”

Section: Discussionmentioning

confidence: 99%

Generally-healthy individuals with aberrant bowel movement frequencies show enrichment for microbially-derived blood metabolites associated with reduced kidney function

Johnson

Diener

Levine

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Laboratory-checked levels of HbA1c, total cholesterol (TC), total triglycerides (TG), platelet count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), creatinine, albumin, globulin, high-sensitivity C-reactive protein (hs-CRP), and other assays have been detailed elsewhere [ 19 ]. Individuals’ comorbidities – chronic diseases, such as dyslipidaemia (DLP), hypertension (HTN), CVD (congestive heart failure, coronary heart disease, heart attack, stroke), and cancer, were obtained by physical examination, laboratory tests, or self-report [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Association between weight change and risk of liver fibrosis in adults with type 2 diabetes

Ke,

Xu,

Feng

et al. 2023

J Glob Health

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Background Liver fibrosis plays a key role in the progression of non-alcoholic fatty liver disease to cirrhosis. Considering weight change is known to be closely associated with increased risk of liver fibrosis, we aimed to address a gap in evidence regarding the existence of this association in patients with type 2 diabetes (T2D). Methods We included data on 622 T2D patients and 1618 non-T2D participants from the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES). We assessed liver fibrosis by the median values of liver stiffness measurement (LSM). According to the participants' body mass index (BMI) at age 25 (early adulthood), 10 years prior (middle adulthood), and at the 2017-2018 cycle (late adulthood), we categorised weight change patterns into stable non-obese, weight loss, weight gain, and stable obese. We applied logistic regression to association analysis and used population attributable fraction (PAF) to analyses hypothetical prevention regimens. Results The prevalence of liver fibrosis was higher in T2D patients (23.04%) than in non-T2D participants (6.70%), while weight change was associated with a greater risk of fibrosis in the former compared to the latter group. Compared with T2D patients in the stable non-obese group, stable obese individuals from 10 years prior to the 2017-2018 cycle had the highest risk of developing liver fibrosis, corresponding to an adjusted odds ratio (aOR) of 3.13 (95% confidence interval = 1.84-5.48). Absolute weight change patterns showed that the risk of liver fibrosis was highest (aOR = 2.94) when T2D patients gained at least 20 kg of weight from 10 years prior to 2017-2018 cycle. Conclusions Obesity in middle and late adulthood is associated with an increased risk of T2D complicated with liver fibrosis.

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“…The difficulties with defecation experienced by elderly patients may lead to cardiovascular and cerebrovascular accidents, thereby increasing the risk of sudden death 10. Concurrently, CC also serves as a risk factor for severe conditions such as colon cancer 11 12. The main treatments for CC are laxative use and lifestyle modifications 13.…”

Section: Introductionmentioning

confidence: 99%

“… 10 Concurrently, CC also serves as a risk factor for severe conditions such as colon cancer. 11 12 The main treatments for CC are laxative use and lifestyle modifications. 13 However, drug therapy may occasionally lead to dependency, potentially exacerbating symptoms or causing complications.…”

Section: Introductionmentioning

confidence: 99%

Abdominal massage for chronic constipation in the elderly: a systematic review and meta-analysis protocol

Yuan,

Wang,

Zhou

et al. 2024

BMJ Open

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IntroductionChronic constipation (CC) is a highly prevalent health challenge that is particularly challenging to treat in elderly patients. Although lifestyle guidance and laxative therapy often yield positive outcomes, patients occasionally struggle with maintaining dietary control. Therefore, identifying an economical and safe alternative therapy to the existing treatment methods documented in the international literature is necessary. This systematic review and meta-analysis aims to evaluate the efficacy and safety of abdominal massage in elderly patients with CC to provide a basis for future mechanistic research.Methods and analysisElectronic searches will be conducted to identify clinical randomised controlled trials in various databases, including Web of Science, PubMed, Cumulated Index to Nursing and Allied Health Literature, Cochrane Library, Embase, Airiti Library, Chinese National Knowledge Infrastructure Databases, Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database and Wan Fang Database. Relevant data will be extracted, and a meta-analysis will be conducted using Reviewer Manager V.5.4. Quality and risk assessments of the included studies will be performed, and the outcome indicators of the trials will be observed. This review will evaluate abdominal massage as a treatment option for relieving symptoms and improving quality of life in elderly patients with CC. Moreover, it will provide additional insights for clinical treatment and mechanistic studies. The search will be performed following the publication of this protocol (estimated to occur on 30 December 2023).Ethics and disseminationAs this is a literature review, ethics approval will not be required. We will disseminate the findings of this study to publications in peer-reviewed journals as well as presentations at relevant national and international conferences.PROSPERO registration numberCRD42023408629.

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Association of abnormal bowel health with major chronic diseases and risk of mortality

Cited by 18 publications

References 35 publications

Generally-healthy individuals with aberrant bowel movement frequencies show enrichment for microbially-derived blood metabolites associated with reduced kidney function

Generally-healthy individuals with aberrant bowel movement frequencies show enrichment for microbially-derived blood metabolites associated with reduced kidney function

Association between weight change and risk of liver fibrosis in adults with type 2 diabetes

Abdominal massage for chronic constipation in the elderly: a systematic review and meta-analysis protocol

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