Hong Brian Younho, Giang Raymond, Mbuagbaw Lawrence, Larche Maggie, Thabane Lehana
Bachelor of Health Sciences (Honours) Program, McMaster University, Hamilton, ON, Canada.
Statistics for Health (Honours), University of Waterloo, Waterloo, ON, Canada.
Syst Rev. 2015 Dec 30;4:188. doi: 10.1186/s13643-015-0176-2.
Up to 90% of people with scleroderma have gastrointestinal (GI) problems such as constipation, bloating, diarrhea, and malabsorption. These problems significantly impair quality of life. Our objective was to determine the risk factors for gastrointestinal issues in people with scleroderma.
We conducted a systematic review of observational studies that report GI problems in patients with scleroderma along with the associated risk factors. We were interested in any GI problem and any risk factor as long as the study included patients diagnosed with scleroderma according to the 1980 or 2013 American College of Rheumatology guideline. We searched the following databases: CINAHL, EMBASE, LILACS, MEDLINE, and Web of Science for relevant articles from June 1884 to May 2014. Two authors independently screened citations and full text articles and extracted data. Discrepancies were resolved by consensus or by consulting a third author. Methodological quality of included studies was assessed using the Newcastle-Ottawa Scale.
After removing duplicates, 645 unique citations were identified. A total of three studies, three cross-sectional (n = 64, n = 42, n = 606), were included in this systematic review. Collectively, these three studies explored Helicobacter pylori and smoking status as risk factors. We found conflicting evidence on the role of H. pylori with two studies showing opposite yet statistically significant results. One moderate quality study showed smoking as a risk factor. Key limitations include the small sample sizes of two studies and poor study designs to draw causal links.
There is insufficient evidence to describe the risk factors for GI problems in patients with scleroderma. Longitudinal observational studies are warranted in patients with scleroderma.
PROSPERO CRD42014010707.
高达90%的硬皮病患者存在胃肠道（GI）问题，如便秘、腹胀、腹泻和吸收不良。这些问题严重损害生活质量。我们的目的是确定硬皮病患者胃肠道问题的风险因素。
我们对观察性研究进行了系统评价，这些研究报告了硬皮病患者的GI问题以及相关风险因素。只要研究纳入了根据1980年或2013年美国风湿病学会指南诊断为硬皮病的患者，我们对任何GI问题和任何风险因素都感兴趣。我们检索了以下数据库：CINAHL、EMBASE、LILACS、MEDLINE和科学网，以查找1884年6月至2014年5月的相关文章。两位作者独立筛选文献和全文文章并提取数据。分歧通过协商一致或咨询第三位作者解决。使用纽卡斯尔-渥太华量表评估纳入研究的方法学质量。
去除重复项后，共识别出645条独特的文献。本系统评价共纳入三项研究，三项横断面研究（n = 64，n = 42，n = 606）。总体而言，这三项研究探讨了幽门螺杆菌和吸烟状况作为风险因素。我们发现关于幽门螺杆菌作用的证据相互矛盾，两项研究显示出相反但具有统计学意义的结果。一项中等质量的研究表明吸烟是一个风险因素。主要局限性包括两项研究的样本量小以及研究设计不佳，无法得出因果关系。
没有足够的证据来描述硬皮病患者GI问题的风险因素。有必要对硬皮病患者进行纵向观察性研究。
PROSPERO CRD42014010707。
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