Shen Te-Chun, Lin Cheng-Li, Wei Chang-Ching, Chen Chia-Hung, Tu Chih-Yen, Hsia Te-Chun, Shih Chuen-Ming, Hsu Wu-Huei, Sung Fung-Chang, Kao Chia-Hung
Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
PLoS One. 2016 Apr 19;11(4):e0153911. doi: 10.1371/journal.pone.0153911. eCollection 2016.
There is a demonstrated association between asthma and irritable bowel syndrome (IBS). In this study, we examined the bidirectional association between asthma and IBS using a nationwide database.
We conducted two retrospective cohort studies using data obtained from the National Health Insurance of Taiwan. Study 1 included 29,648 asthma patients newly diagnosed between 2000 and 2010. Study 2 included 29,875 IBS patient newly diagnosed between 2000 and 2010. For each study, four subjects without asthma and IBS were selected, respectively, frequency-matched by sex, age, and the diagnosis date. All four cohorts were followed up until the end of 2011 to estimate incident IBS for Study 1 and incident asthma for study 2. Adjusted hazard ratios (aHRs) were estimated using the Cox proportional hazards model after controlling for sex, age and comorbidities.
The incidence of IBS was 1.89 times higher in the asthma cohort than in the comparison cohort (8.26 vs. 4.36 per 1,000 person-years), with an aHR of 1.57 [95% confidence interval (CI) = 1.47-1.68]. The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities. In contrast, the incidence of asthma was 1.76 times higher in the IBS cohort than the comparison cohort (7.09 vs. 4.03 per 1,000 person-years), with an aHR of 1.54 (95% CI = 1.44-1.64). Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.
The present study suggests a bidirectional association between asthma and IBS. Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.
哮喘与肠易激综合征（IBS）之间已证实存在关联。在本研究中，我们使用全国性数据库研究了哮喘与IBS之间的双向关联。
我们利用从台湾国民健康保险获得的数据进行了两项回顾性队列研究。研究1纳入了2000年至2010年间新诊断的29648例哮喘患者。研究2纳入了2000年至2010年间新诊断的29875例IBS患者。对于每项研究，分别选取4名无哮喘和IBS的受试者，按性别、年龄和诊断日期进行频率匹配。所有四个队列均随访至2011年底，以评估研究1中的IBS发病率和研究2中的哮喘发病率。在控制性别、年龄和合并症后，使用Cox比例风险模型估计调整后的风险比（aHRs）。
哮喘队列中IBS的发病率比对照队列高1.89倍（每1000人年8.26例vs.4.36例），aHR为1.57[95%置信区间（CI）=1.47-1.68]。在按性别、年龄和合并症情况划分的所有亚组中，aHR均保持显著。相比之下，IBS队列中哮喘的发病率比对照队列高1.76倍（每1000人年7.09例vs.4.03例），aHR为1.54（95%CI=1.44-1.64）。同样，在按性别、年龄和合并症情况划分的所有亚组中，aHR均保持显著。
本研究提示哮喘与IBS之间存在双向关联。特应性可能是这种关联背后的共同病理生理机制，值得进一步研究。
