Department of Internal Medicine, Division of Gastroenterology, Jewish General Hospital, McGill University School of Medicine, Canada.
Department of Emergency Medicine, Biostatistics, Jewish General Hospital, McGill University School of Medicine, Canada.
Med Hypotheses. 2018 Jan;110:31-37. doi: 10.1016/j.mehy.2017.10.020. Epub 2017 Nov 2.
Irritable Bowel Syndrome (IBS) shares overlapping symptoms and some features of pathogenesis with Inflammatory Bowel Diseases (IBD: Crohn's disease [CD], and Ulcerative Colitis [UC]). Geographic markers such as latitude/sunshine and more recently lactase population distributions are found to be correlated with IBD. As a result of clinical and pathogenic similarities between the 2 conditions, some authorities questioned whether a connection exists between them. We compare IBS directly with IBD, and indirectly with geographic markers associated with IBD, in order to evaluate possible evolutionary links between IBS and IBD. Similar correlations may link IBS as a precursor to IBD and possibly other conditions which are geographically connected with IBD. Data from four systematic reviews on IBD incidence and prevalence, IBS prevalence, and lactase distributions were included. Pearson's correlations were used for comparisons, with IBD values log-transformed because of skewed distribution. The articles provided 18-28 complete set of national data. Direct comparison between IBS and IBD showed no significant correlations (r = -0.14, r = -0.06 for CD and UC prevalence, r = -0.10 for CD incidence). Indirect comparisons also failed to show correlations of IBS with lactase distributions (r = -0.17), sunshine (r = -0.2) or latitude (r = 0.097); however, there was significant correlation between lactase distributions and CD incidence (r = -0.84), prevalence (r = -0.55) and UC prevalence (r = -0.59). Both sunshine (r= -0.53) and latitude (r = 0.58) are also significantly related to CD incidence. It is concluded that IBS and IBD do not follow similar global geographic patterns. This suggests a lack of an evolutionary genetic background coincident with emergence of lactase persistence. As well, vitamin D has no obvious impact on development of IBS. Similarities with IBD may result from sub groups (not yet identified) within the current Rome criteria of IBS. Alternatively limited intestinal gut-brain responses to host microbial interactions may result in similar overlap features in both.
肠易激综合征（IBS）与炎症性肠病（IBD：克罗恩病[CD]和溃疡性结肠炎[UC]）在症状和发病机制上有重叠之处。人们发现，纬度/阳光等地理标志以及最近的乳糖酶人群分布与 IBD 相关。由于这两种疾病在临床和发病机制上存在相似性，一些权威人士质疑它们之间是否存在联系。我们将 IBS 与 IBD 直接进行比较，并与与 IBD 相关的地理标志间接进行比较，以评估 IBS 和 IBD 之间可能存在的进化联系。类似的相关性可能将 IBS 与 IBD 联系起来，并可能与 IBD 存在地理联系的其他疾病联系起来。我们纳入了四项关于 IBD 发病率和患病率、IBS 患病率和乳糖酶分布的系统评价的数据。使用 Pearson 相关系数进行比较，由于分布偏斜，IBD 值进行了对数转换。这些文章提供了 18-28 组完整的国家数据。IBS 与 IBD 之间的直接比较没有显示出显著的相关性（CD 和 UC 患病率的 r 值分别为-0.14 和-0.06，CD 发病率的 r 值为-0.10）。间接比较也未能显示 IBS 与乳糖酶分布（r=-0.17）、阳光（r=-0.2）或纬度（r=0.097）之间的相关性；然而，乳糖酶分布与 CD 发病率（r=-0.84）、患病率（r=-0.55）和 UC 患病率（r=-0.59）之间存在显著相关性。阳光（r=-0.53）和纬度（r=0.58）也与 CD 发病率显著相关。结论是，IBS 和 IBD 没有遵循相似的全球地理模式。这表明，在乳糖酶持续存在的情况下，缺乏与之一致的进化遗传背景。同样，维生素 D 对 IBS 的发展没有明显影响。与 IBD 的相似性可能是由于当前 IBS 的罗马标准中的亚组（尚未确定）所致。或者，宿主微生物相互作用引起的肠道-大脑反应有限，可能导致这两种疾病在重叠特征上相似。
Clin Gastroenterol Hepatol. 2006-5
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