Long-term risk of inflammatory bowel disease in patients with irritable bowel syndrome: the cross-sectional and longitudinal relationship.

IF 5.5 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology Pub Date : 2025-09-28 DOI:10.1007/s00535-025-02304-1

Huixin Song, Yesheng Zhou, Si Liu, Qian Zhang, Shutian Zhang, Shengtao Zhu, Shanshan Wu

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引用次数: 0

Abstract

Background: Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are distinct gastrointestinal disorders with overlapping symptoms and pathophysiological background. The long-term risk of IBD is unclear in IBS patients.

Methods: Overall, 447,631 participants free of IBD at baseline (2006-2010) and 76,992 individuals who completed Digestive Health Questionnaire (2017-2018) from UK Biobank were enrolled in longitudinal cohort and cross-sectional analysis, respectively. The primary outcome was incident IBD in the cohort design, and Cox proportional hazards model was conducted to estimate the associated hazard ratio (HR). Prevalent IBD was defined as primary outcome in the cross-sectional design, and logistic regression was performed to estimate the associated odds ratio (OR).

Results: In the cohort design, 2,916 incident IBD cases were identified during a median 14.2 years' follow-up, with 2,097 ulcerative colitis (UC) and 1,015 Crohn's disease (CD), respectively. IBS patients had a 68%, 60%, and 104% increased risk of IBD (HR = 1.68, 95% CI:1.47-1.92), UC (HR = 1.60, 1.36-1.89), and CD (HR = 2.04, 1.66-2.51) versus non-IBS participants. Moreover, a greater risk of incident IBD persisted in IBS patients even after 10 years' duration (HR = 1.55, 1.27-1.89). In cross-sectional analysis, IBS patients exhibited significantly elevated odds of IBD (OR = 2.40, 2.14-2.70), UC (OR = 2.18, 1.92-2.48), and CD (OR = 3.15, 2.68-3.70). A greater odds of IBD was observed among all IBS subtypes, with IBS-D showing the highest odds (OR = 3.72, 3.24-4.28).

Conclusions: The risk of incident IBD, either UC or CD, is significantly higher in IBS patients compared with the general population, especially in IBS-D patients.

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肠易激综合征患者炎症性肠病的长期风险：横断面和纵向关系

背景：肠易激综合征（IBS）和炎症性肠病（IBD）是不同的胃肠道疾病，具有重叠的症状和病理生理背景。肠易激综合征患者患IBD的长期风险尚不清楚。方法：总体而言，447,631名基线（2006-2010年）无IBD的参与者和76,992名完成了英国生物银行消化健康问卷（2017-2018年）的个体分别被纳入纵向队列和横断面分析。在队列设计中，主要结局为IBD事件，采用Cox比例风险模型估计相关风险比（HR）。在横断面设计中，普遍IBD被定义为主要结局，并进行逻辑回归来估计相关的优势比（OR）。结果：在队列设计中，在中位14.2年的随访期间，确定了2,916例IBD事件，其中溃疡性结肠炎（UC）为2,097例，克罗恩病（CD）为1,015例。与非IBS患者相比，IBS患者IBD （HR = 1.68, 95% CI:1.47-1.92）、UC （HR = 1.60, 1.36-1.89）和CD （HR = 2.04, 1.66-2.51）的风险分别增加68%、60%和104%。此外，IBS患者发生IBD的风险甚至在10年后仍然存在（HR = 1.55, 1.27-1.89）。在横断面分析中，IBS患者出现IBD （OR = 2.40, 2.14-2.70）、UC （OR = 2.18, 1.92-2.48）和CD （OR = 3.15, 2.68-3.70）的几率显著升高。在所有IBS亚型中，IBD的发生率更高，其中IBS- d的发生率最高（OR = 3.72, 3.24-4.28）。结论：IBS患者发生IBD （UC或CD）的风险明显高于一般人群，尤其是IBS- d患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.