AbstractObesity has become a global public health problem, and its relationship with gastrointestinal diseases has become a major concern. The visceral adiposity index (VAI) is a novel index to assess the distribution and content of visceral fat, and this study aimed to investigate the association between VAI and bowel habits (chronic diarrhea, chronic constipation) and inflammatory bowel disease (IBD).

肥胖已成为全球公共卫生问题，其与胃肠道疾病的关系已成为人们关注的主要问题。内脏肥胖指数（VAI）是一种评估内脏脂肪分布和含量的新指标，本研究旨在探讨VAI与排便习惯（慢性腹泻，慢性便秘）和炎症性肠病（IBD）之间的关系。

The 2005–2010 National Health and Nutrition Examination Survey (NHANES) dataset was used for the cross-sectional survey. Bowel habits and IBD were defined by self-report. Multiple logistic regression models were used to test the linear association of VAI with bowel habits and IBD. Fitted smoothed curves and threshold effects analyses were used to characterize nonlinear relationships.

横断面调查使用了2005-2010年国家健康与营养检查调查（NHANES）数据集。排便习惯和IBD由自我报告定义。多元逻辑回归模型用于测试VAI与排便习惯和IBD的线性关联。拟合平滑曲线和阈值效应分析用于表征非线性关系。

This cross-sectional study included 10,391 adults (≥ 20 years). After adjusting for covariates, there was a significant negative association between VAI and chronic constipation (OR [95% CI]: 0.97 [0.95, 1.00]) but no significant association with IBD (OR [95% CI]: 0.97 [0.87, 1.07]). Additionally, there was a nonlinear association between VAI and chronic diarrhea with a breakpoint of 3.08, with a positive correlation between the two on the left side of the breakpoint and no statistical significance on the right side.

这项横断面研究包括10391名成年人（≥20岁）。调整协变量后，VAI与慢性便秘呈显着负相关（OR[95%CI]:0.97[0.95，1.00]），而与IBD无显着相关性（OR[95%CI]:0.97[0.87，1.07]）。此外，VAI与慢性腹泻之间存在非线性关联，断点为3.08，断点左侧两者呈正相关，右侧无统计学意义。

Subgroup analyses and interaction tests showed that maintaining sleep health was associated with a low risk of chronic constipation. Elevated VAI levels were negatively associated with chronic constipation, and elevated levels were positively associated with chronic diarrhea at VAI < 3.08. This reminds us that maintaining moderate levels of visceral fat may prevent the onset of chronic constipation and circumvent the risk of chronic diarrhea.

亚组分析和相互作用测试表明，维持睡眠健康与慢性便秘的低风险相关。VAI水平升高与慢性便秘呈负相关，VAI水平升高与慢性腹泻呈正相关。这提醒我们，保持适度的内脏脂肪水平可以预防慢性便秘的发作，并规避慢性腹泻的风险。

Notably, maintaining healthy sleep m.

值得注意的是，保持健康的睡眠m。

Introduction

简介

With the changes in people’s increasingly rich diets, a variety of gastrointestinal symptoms are on the rise. The prevalence of chronic diarrhea in the United States is estimated to be 11-30% of the total population, affecting 6.6% of the U.S. population1,2, and the combined global prevalence of chronic constipation is 14%, with little variation by geographic region3, and the two have become one of the most common gastrointestinal disorders worldwide.

随着人们饮食日益丰富的变化，各种胃肠道症状呈上升趋势。据估计，美国慢性腹泻的患病率占总人口的11-30%，影响美国人口的6.6%1,2，全球慢性便秘的综合患病率为14%，地理区域差异很小3，两者已成为全球最常见的胃肠道疾病之一。

IBD is an idiopathic inflammatory disease of the gastrointestinal tract, including Crohn’s disease (CD) and ulcerative colitis (UC), in which chronic diarrhea is the most prevalent symptom4. It has been reported that more than 3 million people in the United States and Europe suffer from IBD, with the prevalence increasing on all continents and incurring high healthcare costs5,6.Obesity is associated with a variety of gastrointestinal disorders and is thought to be a risk factor for a variety of gastrointestinal symptoms, but the association between obesity and lower gastrointestinal symptoms remains unclear.

IBD是一种胃肠道特发性炎症性疾病，包括克罗恩病（CD）和溃疡性结肠炎（UC），其中慢性腹泻是最常见的症状4。据报道，美国和欧洲有300多万人患有IBD，各大洲的患病率都在增加，医疗费用也很高[5,6]。肥胖与多种胃肠道疾病有关，被认为是各种胃肠道症状的危险因素，但肥胖与下消化道症状之间的关联仍不清楚。

Although some studies have shown that the risk of developing gastrointestinal symptoms increases with increasing obesity7,8,9, there have also been some conflicting findings10,11,12. The World Obesity Federation released the “2023 World Obesity Atlas” still uses the body mass index (BMI) to assess the degree of “obesity”, but in October of the same year, the journal Nature pointed out that the BMI is a somewhat crude indicator to determine the health risks, and can not be used to measure the degree of health of the body, and it does not measure the body fat, which is the body fat is not to be ignored in the part of the obesity13.VAI is a novel gender-specific index based on waist circumference (WC), BMI, triglycerides .

虽然一些研究表明，随着肥胖程度的增加，出现胃肠道症状的风险增加7,8,9，但也有一些相互矛盾的发现10,11,12。世界肥胖联合会发布的《2023年世界肥胖地图集》仍然使用体重指数（BMI）来评估“肥胖”程度，但同年10月，《自然》杂志指出，BMI是确定健康风险的一个有点粗糙的指标，不能用来衡量身体的健康程度，也不能衡量身体脂肪，这是身体脂肪在肥胖中不可忽视的部分13.VAI是一种基于腰围（WC）、BMI、甘油三酯的新型性别特异性指数。

Data availability

数据可用性

Publicly available datasets were analyzed in this study. These data can be found at: www.cdc.gov/nchs/nhanes/.

本研究分析了公开可用的数据集。这些数据可以在www.cdc.gov/nchs/nhanes/上找到。

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Karaskova，E。等人。脂肪组织在炎症性肠病中的作用。国际分子科学杂志22https://doi.org/10.3390/ijms22084226（2021年）。Yang，S.等人，《成年男性和女性睡眠时间与慢性便秘的关系：国家健康与营养检查调查（2005-2010）的结果》。

Front. Neurol.13, 903273. https://doi.org/10.3389/fneur.2022.903273 (2022).Article .

Front. Neurol.13, 903273. https://doi.org/10.3389/fneur.2022.903273 (2022).Article .

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Nakagawa, H. et al. Poor sleep quality as a risk factor for Constipation among Community-Dwelling older adults in Japan. Cureus. 15, e46175. https://doi.org/10.7759/cureus.46175 (2023).Article

Nakagawa，H.等人。睡眠质量差是日本社区老年人便秘的危险因素。Cureus公司。15，e46175。https://doi.org/10.7759/cureus.46175（2023年）。文章

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Download referencesAcknowledgementsThanks to all the authors for their contributions.FundingThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.Author informationAuthors and AffiliationsNanjing University of Chinese Medicine, Nanjing, ChinaXiaoxian Yang, Manli Wang, Lang Ren, Kinyu Shon, Guoliang Cui, Yiyao Cheng & Zhiguang SunXuzhou Hospital of Traditional Chinese Medicine, Xuzhou, ChinaXiaohong WangAuthorsXiaoxian YangView author publicationsYou can also search for this author in.

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PubMed Google ScholarContributionsXiaoxian Yang and Manli Wang conceptualized the study. Statistical analysis was done by Xiaoxian Yang and Kinyu Shon. The manuscript was reviewed by Lang Ren, Guoliang Cui, Yiyao Cheng, Zhiguang Sun and Xiaohong Wang. All authors reviewed and approved the final version of the manuscript.Corresponding authorsCorrespondence to.

PubMed谷歌学术贡献杨晓贤和王曼丽将这项研究概念化。统计分析由杨晓贤和肖金宇完成。该手稿由郎仁，崔国良，程一尧，孙志光和王晓红审阅。。通讯作者通讯。

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Reprints and permissionsAbout this articleCite this articleYang, X., Wang, M., Ren, L. et al. Association between visceral adiposity index and bowel habits and inflammatory bowel disease: a cross-sectional study.

转载和许可本文引用本文Yang，X.，Wang，M.，Ren，L。等人。内脏肥胖指数与排便习惯和炎症性肠病之间的关联：横断面研究。

Sci Rep 14, 23923 (2024). https://doi.org/10.1038/s41598-024-73864-0Download citationReceived: 31 January 2024Accepted: 22 September 2024Published: 13 October 2024DOI: https://doi.org/10.1038/s41598-024-73864-0Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsVisceral adiposity indexChronic diarrheaChronic constipationInflammatory bowel diseaseCross-sectional study

关键词全身肥胖指数慢性腹泻慢性便秘炎症性肠病横断面研究