Department of Medicine, Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland.
J Crohns Colitis. 2011 Feb;5(1):41-7. doi: 10.1016/j.crohns.2010.09.008. Epub 2010 Oct 30.
Patients with inflammatory bowel diseases (IBD) show increased risk for other immune-mediated diseases such as arthritis, ankylosing spondylitis, and some pulmonary diseases. Less is known about the prevalence of other chronic diseases in IBD, and the impact of comorbidity on health-related quality of life (HRQoL).
The study population comprised 2831 IBD patients recruited from the National Health Insurance register and from a patient-association register. Study subjects completed generic 15D and disease-specific IBDQ questionnaires. The Social Insurance Institution of Finland provided data on other chronic diseases entitling patients to reimbursed medication. For each study subject, two controls, matched for age, sex, and hospital district, were chosen.
A significant increase existed in prevalence of connective tissue diseases, pernicious anemia and asthma. Furthermore, coronary heart disease (CHD) occurred significantly more frequently in IBD patients than in their peers (p=0.004). The difference was, however, more clearly seen in females (p=0.014 versus 0.046 in males). Active and long-lasting IBD were risk factors. Concomitant other chronic diseases appeared to impair HRQoL. Asthma, hypertension and psychological disorders had an especially strong negative impact on HRQoL, as observed with both the generic and disease-specific HRQoL tools.
In addition to many immune-mediated diseases, CHD appeared to be more common in IBD than in control patients, especially in females. The reason is unknown, but chronic inflammation may predispose to atherosclerosis. This finding should encourage more efficacious management of underlying cardiovascular risk factors, and probably also inflammatory activity in IBD.
炎症性肠病（IBD）患者发生关节炎、强直性脊柱炎和某些肺部疾病等其他免疫介导性疾病的风险增加。关于 IBD 患者中其他慢性疾病的患病率以及合并症对健康相关生活质量（HRQoL）的影响，了解较少。
研究人群包括从国家健康保险登记处和患者协会登记处招募的 2831 名 IBD 患者。研究对象完成了通用 15D 和疾病特异性 IBDQ 问卷。芬兰社会保险局提供了可报销药物的其他慢性疾病的数据。为每位研究对象选择了两名年龄、性别和医院病房相匹配的对照者。
结缔组织疾病、恶性贫血和哮喘的患病率显著增加。此外，与同龄人相比，IBD 患者的冠心病（CHD）发生率显著更高（p=0.004）。但是，这种差异在女性中更为明显（p=0.014 对男性中的 0.046）。活动性和持续性 IBD 是危险因素。同时存在其他慢性疾病似乎会损害 HRQoL。哮喘、高血压和心理障碍对 HRQoL 具有特别不利的影响，这两种工具均观察到了这一点。
除了许多免疫介导性疾病外，CHD 在 IBD 患者中似乎比在对照患者中更为常见，尤其是在女性中。原因尚不清楚，但慢性炎症可能易患动脉粥样硬化。这一发现应鼓励更有效地管理潜在的心血管危险因素，可能还包括 IBD 中的炎症活动。
