Department of Gastroenterology and Hepatology, Hospital of Southwest Jutland, 6700 Esbjerg, Denmark.
Department of Medical Gastroenterology S, Odense University Hospital, 5000 Odense, Denmark.
World J Gastroenterol. 2017 Sep 7;23(33):6137-6146. doi: 10.3748/wjg.v23.i33.6137.
To investigate whether immune mediated diseases (IMD) are more frequent in patients with inflammatory bowel disease (IBD).
In this population based registry study, a total of 47325 patients with IBD were alive and registered in the Danish National Patient Registry on December 16, 2013. Controls were randomly selected from the Danish Civil Registration System (CRS) and matched for sex, age, and municipality. We used ICD 10 codes to identify the diagnoses of the included patients. The IBD population was divided into three subgroups: Ulcerative colitis (UC), Crohn's disease (CD) and Both the latter referring to those registered with both diagnoses. Subsequently, odds-ratios (OR) and 95%CI were obtained separately for each group and their respective controls. The use of Bonferoni post-test correction adjusted the significance level to < 0.00125. -values were estimated using Fisher's exact test.
There were significantly more women than men in the registry, and a greater percentage of comorbidity in the IBD groups ( < 0.05). Twenty different IMDs were all significantly more frequent in the IBD group. Sixteen were associated with UC versus twelve with CD. In both UC and CD ORs were significantly increased ( < 0.00125) for primary sclerosing cholangitis (PSC), celiac disease, type 1 diabetes (T1D), sarcoidosis, asthma, iridocyclitis, psoriasis, pyoderma gangrenosum, rheumatoid arthritis, and ankylosing spondylitis. Restricted to UC ( < 0.00125) were autoimmune hepatitis, primary biliary cholangitis, Grave's disease, polymyalgia rheumatica, temporal arteritis , and atrophic gastritis. Restricted to CD ( < 0.00125) were psoriatic arthritis and episcleritis. Restricted to women with UC ( < 0.00125) were atrophic gastritis, rheumatoid arthritis, temporal arteritis, and polymyalgia rheumatica. Restricted to women with CD were episcleritis, rheumatoid arthritis, and psoriatic arthritis. The only disease restricted to men ( < 0.00125) was sarcoidosis.
Immune mediated diseases were significantly more frequent in patients with IBD. Our results strengthen the hypothesis that some IMDs and IBD may have overlapping pathogenic pathways.
探讨免疫介导性疾病（IMD）在炎症性肠病（IBD）患者中是否更为常见。
在这项基于人群的登记研究中，共有 47325 名 IBD 患者于 2013 年 12 月 16 日在世卫组织生存并登记在丹麦国家患者登记处。对照者随机从丹麦民事登记系统（CRS）中选出，并按性别、年龄和市匹配。我们使用 ICD-10 代码来确定纳入患者的诊断。将 IBD 人群分为三组：溃疡性结肠炎（UC）、克罗恩病（CD）和两者（后两者指同时登记这两种诊断的患者）。随后，分别为每组及其各自的对照组获得比值比（OR）和 95%CI。使用 Bonferoni 后检验校正了显著性水平<0.00125。使用 Fisher 精确检验估计 P 值。
登记处的女性明显多于男性，IBD 组的合并症比例也较大（<0.05）。20 种不同的 IMD 均在 IBD 组中显著更为常见。16 种与 UC 相关，12 种与 CD 相关。在 UC 和 CD 中，原发性硬化性胆管炎（PSC）、乳糜泻、1 型糖尿病（T1D）、结节病、哮喘、虹膜炎、银屑病、坏疽性脓皮病、类风湿关节炎和强直性脊柱炎的 OR 均显著增加（<0.00125）。仅限于 UC（<0.00125）的还有自身免疫性肝炎、原发性胆汁性胆管炎、格雷夫斯病、多发性肌痛、颞动脉炎和萎缩性胃炎。仅限于 CD（<0.00125）的还有银屑病关节炎和巩膜炎。仅限于女性 UC（<0.00125）的还有萎缩性胃炎、类风湿关节炎、颞动脉炎和多发性肌痛。仅限于女性 CD 的还有巩膜炎、类风湿关节炎和银屑病关节炎。唯一限于男性（<0.00125）的疾病是结节病。
免疫介导性疾病在 IBD 患者中更为常见。我们的结果加强了一些 IMD 和 IBD 可能具有重叠发病途径的假设。
