{"title":"社会经济差异与肠易激综合征风险：一项具有中介分析的队列研究。","authors":"Yesheng Zhou, Si Liu, Qian Zhang, Shutian Zhang, Shengtao Zhu, Shanshan Wu","doi":"10.1016/j.cgh.2025.08.034","DOIUrl":null,"url":null,"abstract":"<p><strong>Background & aims: </strong>The study sought to investigate the association between socioeconomic status (SES) and risk of incident irritable bowel syndrome (IBS), and the mediating role of lifestyle factors.</p><p><strong>Methods: </strong>Participants free of IBS at recruitment were included in this retrospective analysis of a prospectively collected cohort (N = 353,790). SES was assessed through household income, education, and employment status, with different patterns identified through latent class analysis. Healthy lifestyle score was calculated including never smoking, moderate alcohol consumption, healthy diet, regular physical activity, normal body mass index, and healthy sleep duration. The primary endpoint was incident IBS. A Cox proportional hazards model with sequential mediation analysis was used to estimate the association and mediation effect.</p><p><strong>Results: </strong>During a median follow-up of 14.5 years, 7240 (2.1%) incident IBS cases were identified. Overall, 94,660 (26.7%), 186,317 (52.7%), and 72,813 (20.6%) participants were classified into low, medium, and high SES patterns, respectively. A high SES pattern was associated with lower IBS risk vs a low SES pattern (hazard ratio, 0.61; 95% confidence interval, 0.57-0.66), with 10.2% of effect mediated by a healthy lifestyle score. Similar findings were observed for SES scores. Regarding individual SES items, higher household income and education and employed status were linked to 8%-32% lower IBS risk, with 5.6%-20.8% of mediation proportions. Notably, individuals with high SES pattern and healthy lifestyle score of 5 or 6 had a 55% (hazard ratio, 0.45; 95% confidence interval, 0.39-0.51) reduced IBS risk vs those with a low SES pattern and healthy lifestyle score of 0-2.</p><p><strong>Conclusions: </strong>Higher SES is associated with reduced risk of incident IBS with mediation effect of healthy lifestyle factors. Interventions targeting both SES inequalities and lifestyle improvements may help reduce IBS burden.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0000,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Socioeconomic Disparity and Risk of Irritable Bowel Syndrome: A Cohort Study With Mediation Analysis.\",\"authors\":\"Yesheng Zhou, Si Liu, Qian Zhang, Shutian Zhang, Shengtao Zhu, Shanshan Wu\",\"doi\":\"10.1016/j.cgh.2025.08.034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background & aims: </strong>The study sought to investigate the association between socioeconomic status (SES) and risk of incident irritable bowel syndrome (IBS), and the mediating role of lifestyle factors.</p><p><strong>Methods: </strong>Participants free of IBS at recruitment were included in this retrospective analysis of a prospectively collected cohort (N = 353,790). SES was assessed through household income, education, and employment status, with different patterns identified through latent class analysis. Healthy lifestyle score was calculated including never smoking, moderate alcohol consumption, healthy diet, regular physical activity, normal body mass index, and healthy sleep duration. The primary endpoint was incident IBS. A Cox proportional hazards model with sequential mediation analysis was used to estimate the association and mediation effect.</p><p><strong>Results: </strong>During a median follow-up of 14.5 years, 7240 (2.1%) incident IBS cases were identified. Overall, 94,660 (26.7%), 186,317 (52.7%), and 72,813 (20.6%) participants were classified into low, medium, and high SES patterns, respectively. A high SES pattern was associated with lower IBS risk vs a low SES pattern (hazard ratio, 0.61; 95% confidence interval, 0.57-0.66), with 10.2% of effect mediated by a healthy lifestyle score. Similar findings were observed for SES scores. Regarding individual SES items, higher household income and education and employed status were linked to 8%-32% lower IBS risk, with 5.6%-20.8% of mediation proportions. Notably, individuals with high SES pattern and healthy lifestyle score of 5 or 6 had a 55% (hazard ratio, 0.45; 95% confidence interval, 0.39-0.51) reduced IBS risk vs those with a low SES pattern and healthy lifestyle score of 0-2.</p><p><strong>Conclusions: </strong>Higher SES is associated with reduced risk of incident IBS with mediation effect of healthy lifestyle factors. Interventions targeting both SES inequalities and lifestyle improvements may help reduce IBS burden.</p>\",\"PeriodicalId\":10347,\"journal\":{\"name\":\"Clinical Gastroenterology and Hepatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":12.0000,\"publicationDate\":\"2025-09-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cgh.2025.08.034\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cgh.2025.08.034","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Socioeconomic Disparity and Risk of Irritable Bowel Syndrome: A Cohort Study With Mediation Analysis.
Background & aims: The study sought to investigate the association between socioeconomic status (SES) and risk of incident irritable bowel syndrome (IBS), and the mediating role of lifestyle factors.
Methods: Participants free of IBS at recruitment were included in this retrospective analysis of a prospectively collected cohort (N = 353,790). SES was assessed through household income, education, and employment status, with different patterns identified through latent class analysis. Healthy lifestyle score was calculated including never smoking, moderate alcohol consumption, healthy diet, regular physical activity, normal body mass index, and healthy sleep duration. The primary endpoint was incident IBS. A Cox proportional hazards model with sequential mediation analysis was used to estimate the association and mediation effect.
Results: During a median follow-up of 14.5 years, 7240 (2.1%) incident IBS cases were identified. Overall, 94,660 (26.7%), 186,317 (52.7%), and 72,813 (20.6%) participants were classified into low, medium, and high SES patterns, respectively. A high SES pattern was associated with lower IBS risk vs a low SES pattern (hazard ratio, 0.61; 95% confidence interval, 0.57-0.66), with 10.2% of effect mediated by a healthy lifestyle score. Similar findings were observed for SES scores. Regarding individual SES items, higher household income and education and employed status were linked to 8%-32% lower IBS risk, with 5.6%-20.8% of mediation proportions. Notably, individuals with high SES pattern and healthy lifestyle score of 5 or 6 had a 55% (hazard ratio, 0.45; 95% confidence interval, 0.39-0.51) reduced IBS risk vs those with a low SES pattern and healthy lifestyle score of 0-2.
Conclusions: Higher SES is associated with reduced risk of incident IBS with mediation effect of healthy lifestyle factors. Interventions targeting both SES inequalities and lifestyle improvements may help reduce IBS burden.
期刊介绍：
Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion.
As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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