Yeh Hui-Wen, Chien Wu-Chien, Chung Chi-Hsiang, Hu Je-Ming, Tzeng Nian-Sheng
Institute of Bioinformatics and System Biology, National Chiao-Tung University, Hsin-Chu, Taiwan.
Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Taiwan.
Int J Clin Pract. 2018 Jul;72(7):e13212. doi: 10.1111/ijcp.13212. Epub 2018 Jun 19.
This cohort study aimed to investigate the association between irritable bowel syndrome (IBS) and the risk of developing psychiatric disorders.
Utilizing the National Health Insurance Research Database (NHIRD) of Taiwan, IBS patients were identified and compared with age, sex, and index year-matched controls (1:3).
Of the IBS subjects, 3934 in 22 356 (17.60%, or 1533.68 per 100 000 person-years) developed psychiatric disorders when compared with 6127 in 67 068 (9.14%, or 802 per 100 000 person-years) in the non-IBS control group. Fine and Gray's survival analysis revealed that the study subjects were more likely to develop psychiatric disorders. The crude hazard ratio (HR) is 3.767 (95% CI: 3.614-3.925, P < .001), and the adjusted HR is 3.598 (95% CI: 3.452-3.752, P < .001) in the risk of developing psychiatric disorders after being adjusted for age, sex, comorbidities, geographical area of residence, urbanisation level of residence, and monthly insurance premiums. The cohort study revealed that IBS subjects were associated with an increased risk of anxiety, depression, bipolar, and sleep disorders.
This cohort study, using NHIRD, shows evidence support that patients with IBS have a 3.6-fold risk of developing psychiatric disorders. Other large or national datasets should be done to explore to underlying mechanisms.
本队列研究旨在调查肠易激综合征(IBS)与发生精神障碍风险之间的关联。
利用台湾地区国民健康保险研究数据库(NHIRD),识别出IBS患者,并与年龄、性别和索引年份匹配的对照组(1:3)进行比较。
在IBS受试者中,22356人中有3934人(17.60%,即每10万人年中有1533.68人)发生了精神障碍,而非IBS对照组中67068人中有6127人(9.14%,即每10万人年中有802人)发生了精神障碍。Fine和Gray生存分析显示,研究对象更有可能发生精神障碍。在调整年龄、性别、合并症、居住地理区域、居住城市化水平和每月保险费后,发生精神障碍风险的粗风险比(HR)为3.767(95%CI:3.614 - 3.925,P <.001),调整后的HR为3.598(95%CI:3.452 - 3.752,P <.001)。队列研究显示,IBS受试者与焦虑、抑郁、双相情感障碍和睡眠障碍风险增加有关。
这项使用NHIRD的队列研究表明,有证据支持IBS患者发生精神障碍的风险是常人的3.6倍。应该利用其他大型或全国性数据集来探索潜在机制。