Weaver Kristen R, Melkus Gail D'Eramo, Fletcher Jason, Henderson Wendy A
1 Johns Hopkins University, Baltimore, MD, USA.
2 Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
Biol Res Nurs. 2018 May;20(3):312-320. doi: 10.1177/1099800418756733. Epub 2018 Feb 5.
Irritable bowel syndrome (IBS) is a chronic, common disorder of the gastrointestinal tract associated with high psychological comorbidity and diminished quality of life. Patients with IBS display a heightened sensitivity to stress, although the literature is inconsistent as to whether they have a dysregulated stress response. The purpose of the present investigation, a substudy of a larger research effort, was to examine physiological correlates of perceived stress in patients with IBS (cortisol and adrenocorticotropic hormone) and to explore associations between perceived stress and quality of life. A total of 101 participants (35 with IBS [predominant subtypes IBS-constipation and IBS-diarrhea] and 66 healthy controls [HCs]) completed self-report inventories regarding perceived stress and quality of life, and fasting peripheral blood was drawn. Participants with IBS did not differ from the HC in demographic or physiological measures but did differ in psychological measures, reporting significantly higher levels of perceived stress and lower levels of quality of life. Perceived stress and quality of life were not significantly associated in IBS participants. However, differential findings of the stress response were found within IBS participants by sex, race, and subtype. These findings illustrate the heterogeneity of the IBS patient population, underscore the necessity of evaluating larger sample sizes and increasing the diversity of such samples to include males and ethnic minorities, and demonstrate the importance of taking an individualized approach to evaluation and treatment in the IBS patient population.
肠易激综合征（IBS）是一种慢性常见的胃肠道疾病，常伴有较高的心理共病率且生活质量下降。IBS患者对应激表现出更高的敏感性，尽管关于他们的应激反应是否失调，文献报道并不一致。本研究是一项更大规模研究工作的子研究，目的是检查IBS患者感知应激的生理相关性（皮质醇和促肾上腺皮质激素），并探讨感知应激与生活质量之间的关联。共有101名参与者（35名IBS患者[主要亚型为便秘型IBS和腹泻型IBS]和66名健康对照者[HCs]）完成了关于感知应激和生活质量的自我报告问卷，并采集了空腹外周血。IBS患者在人口统计学或生理指标上与健康对照者没有差异，但在心理指标上存在差异，IBS患者报告的感知应激水平显著更高，生活质量水平更低。IBS患者中，感知应激与生活质量没有显著关联。然而，在IBS患者中，按性别、种族和亚型发现了应激反应的不同结果。这些发现说明了IBS患者群体的异质性，强调了评估更大样本量并增加此类样本的多样性以纳入男性和少数族裔的必要性，并证明了对IBS患者群体采取个体化评估和治疗方法的重要性。
