意大利成年人严重肠易激综合征的患病率。一项荟萃分析。

Prevalence of severe irritable bowel syndrome among Italian adults. A meta-analysis.

机构信息

Department of Medical Sciences, University of Ferrara, Ferrara, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2017 Dec;21(24):5751-5764. doi: 10.26355/eurrev_201712_14022.

Abstract

OBJECTIVE

To provide a summary estimate of the prevalence of irritable bowel syndrome (IBS) and IBS with severe symptomatology, stratified by gender and subtype, among Italian adults.

MATERIALS AND METHODS

We searched MedLine and Scopus databases to identify surveys on IBS prevalence among Italian samples, and/or severe IBS prevalence among Caucasian populations, up to June 2017. Random-effect proportion meta-analyses were used to obtain summary estimates of IBS prevalence. Raw numbers of adults with IBS or severe IBS were computed multiplying pooled prevalence estimates by the current Italian adult population. For both IBS and severe IBS, several estimates were provided according to different scenarios, using the pooled estimates from meta-analyses, their highest and lowest 95% confidence intervals (CI), and the lowest prevalence among all individual studies.

RESULTS

The pooled prevalence of IBS among Italian adults, resulting from a meta-analysis of 5 studies including 40,654 subjects, was 7.7% (95% CI: 6.0%-9.7%). The lowest published estimate was 5.4%. The overall number of Italian adults with IBS may thus range between a minimum of 2,736,700 (1,797,800 females; 65.7%) and 4,915,800. From a meta-analysis of 17 studies including 16,873 subjects, the pooled proportion of severe IBS was 23.5% (95% CI: 18.7%-28.7%), with a lowest published estimate of 8.4%. The overall number of Italian adults with severe IBS may thus range between 229,900 (86,600 with constipation-predominant subtype; 70,600 diarrhea-predominant; 72,600 mixed/alternating) and 1,410,800. In a standard, still conservative scenario, based upon the lowest 95% CIs from meta-analyses, the Italians with severe IBS would be 511,800.

CONCLUSIONS

Using an extremely conservative, lowest plausible estimate, no less than 230,000 Italian adults are suffering from severe IBS, requiring appropriate treatment and recognition by healthcare providers. A standardized instrument to measure IBS severity is urgently required to support diagnostic and therapeutic processes, and improve the precision of epidemiological estimates.

摘要

目的

按性别和亚型对意大利成年人中肠易激综合征(IBS)和严重症状 IBS 的患病率进行汇总估计。

材料和方法

我们检索了 MedLine 和 Scopus 数据库,以确定针对意大利样本中 IBS 患病率和/或白种人群中严重 IBS 患病率的调查。采用随机效应比例荟萃分析获得 IBS 患病率的汇总估计值。通过将汇总的患病率估计值乘以当前意大利成年人口数,计算出患有 IBS 或严重 IBS 的成年人的原始人数。对于 IBS 和严重 IBS,根据不同情况提供了几种估计值,使用荟萃分析的汇总估计值、其最高和最低 95%置信区间(CI)以及所有个体研究中的最低患病率。

结果

对纳入的 5 项研究(共 40654 名受试者)进行荟萃分析得出,意大利成年人 IBS 的汇总患病率为 7.7%(95%CI:6.0%-9.7%)。发表的最低估计值为 5.4%。因此,意大利患有 IBS 的成年人人数最低可能为 2736700 人(1797800 名女性;65.7%),最高可能为 4915800 人。对纳入的 17 项研究(共 16873 名受试者)进行荟萃分析得出,严重 IBS 的汇总比例为 23.5%(95%CI:18.7%-28.7%),发表的最低估计值为 8.4%。因此,意大利患有严重 IBS 的成年人人数最低可能为 229900 人(86600 名便秘为主型;70600 名腹泻为主型;72600 名混合/交替型),最高可能为 1410800 人。在一个仍然保守的标准方案中,基于荟萃分析的最低 95%CI,意大利患有严重 IBS 的人数为 511800 人。

结论

使用最低可能的估计值,至少有 230000 名意大利成年人患有严重 IBS,需要适当的治疗并得到医疗保健提供者的认可。迫切需要一种标准化的工具来衡量 IBS 的严重程度,以支持诊断和治疗过程,并提高流行病学估计的准确性。

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