Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
Department of Psychosomatics, University Hospital Basel, University of Basel, Basel, Switzerland.
BMJ Open. 2018 Oct 17;8(10):e019453. doi: 10.1136/bmjopen-2017-019453.
The aim of this study was to describe the body mass index (BMI) distribution in patients with irritable bowel syndrome (IBS) based on the Rome III criteria and to evaluate the association of BMI with symptom severity and quality of life (QOL).
A cross-sectional study was carried out in patients visiting our outpatient functional gastrointestinal disorders specialty clinic. IBS diagnosis was made based on Rome III criteria. IBS symptom severity was investigated using the IBS severity score system. QOL was assessed using the Short Form 36 Health Survey, which consists of physical health and mental health.
366 patients (252 women) who fulfilled Rome III criteria and provided complete BMI data (23.90±5.22 kg/m) were included. Overall, 59.0% of patients with IBS were in the normal weight range, 30.3% were overweight or obese, and 10.7% were underweight. Both physical and mental health decreased significantly with the severity of symptoms (all p<0.01), while controlling for several covariates (age, gender, family status, education status and IBS subtypes). Obesity and symptom severity (β=-0.177,△R=0.037, p<0.01; β=-0.387,△R=0.147, p<0.01) were significant negative factors that influencing physical health. Symptom severity (β=-0.301,△R=0.084, p<0.01) was significant negative factor that influencing mental health. However, BMI didn't account for additional variance in mental health (p>0.05).
Being overweight is a common phenomenon in patients with IBS regardless of IBS subtype. The association between QOL and symptom severity followed a negative dose-response pattern. Patients with higher BMI, especially obese patients, were more frequently in poor physical health. However, this kind of relationship was not found in BMI and mental health.
本研究旨在根据罗马 III 标准描述肠易激综合征（IBS）患者的体重指数（BMI）分布，并评估 BMI 与症状严重程度和生活质量（QOL）的关系。
本研究为一项横断面研究，在我院门诊功能性胃肠疾病专科就诊的患者中进行。根据罗马 III 标准诊断 IBS。采用 IBS 严重程度评分系统评估 IBS 症状严重程度。使用包含生理健康和心理健康的健康调查简表 36 项（Short Form 36 Health Survey）评估 QOL。
共纳入 366 例符合罗马 III 标准且提供完整 BMI 数据的患者（252 例女性，平均 BMI 为 23.90±5.22kg/m）。总体而言，59.0%的 IBS 患者体重正常，30.3%超重或肥胖，10.7%消瘦。控制年龄、性别、家庭状况、教育程度和 IBS 亚型等多个混杂因素后，生理和心理健康均随症状严重程度显著下降（均 p<0.01）。肥胖和症状严重程度（β=-0.177，△R=0.037，p<0.01；β=-0.387，△R=0.147，p<0.01）是影响生理健康的显著负性因素。症状严重程度（β=-0.301，△R=0.084，p<0.01）是影响心理健康的显著负性因素。然而，BMI 对心理健康没有额外的影响（p>0.05）。
无论 IBS 亚型如何，超重都是 IBS 患者的常见现象。QOL 与症状严重程度之间存在负相关关系。BMI 较高，尤其是肥胖患者，生理健康状况更差。然而，在 BMI 和心理健康之间没有发现这种关系。
