Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Gut Liver. 2019 May 15;13(3):333-341. doi: 10.5009/gnl18304.
BACKGROUND/AIMS: The risk of herpes zoster (HZ) among patients with inflammatory bowel disease (IBD) remains unclear in terms of age and metabolic comorbidities, including diabetes mellitus, hypertension, or dyslipidemia. We conducted a nationwide population-based study to investigate the risk of HZ in patients with IBD.
From 2010 to 2013, a retrospective study was performed using claims data in Korea. We compared the incidence of HZ between 30,100 IBD patients (10,517 Crohns disease [CD] and 19,583 ulcerative colitis [UC] patients) and 150,500 non-IBD controls matched by age and sex.
During a mean follow-up of 5.0 years, incidence rates of HZ (per 1,000 person-years) were 13.60, 14.99, and 9.19 in the CD, UC, and control groups, respectively. The risk of HZ was significantly higher in patients with CD (adjusted hazard ratio [HR], 2.13; p<0.001) and UC (adjusted HR, 1.40; p<0.001) than in the controls. The impact of CD on developing HZ was significantly more prominent in younger patients (adjusted HR, 2.61 for age <15, whereas 1.39 for age ≥60; interaction p=0.001) and in patients without metabolic comorbidities (adjusted HR, 2.24, whereas 1.59 in those with metabolic comorbidities; interaction p=0.015). Moreover, the impact of UC on developing HZ significantly increased in younger patients (adjusted HR, 2.51 in age <15, whereas 1.22 in age ≥60; interaction p=0.014) and patients without metabolic comorbidities (adjusted HR, 1.49 whereas 1.16 in those with metabolic comorbidities; interaction p<0.001).
IBD was associated with an increased risk of HZ, especially in younger patients without metabolic comorbidities.
背景/目的：在年龄和代谢合并症（包括糖尿病、高血压或血脂异常）方面，疱疹（HZ）在炎症性肠病（IBD）患者中的风险尚不清楚。我们进行了一项全国性的基于人群的研究，以调查 IBD 患者中 HZ 的风险。
2010 年至 2013 年，使用韩国的索赔数据进行了回顾性研究。我们比较了 30100 例 IBD 患者（10517 例克罗恩病[CD]和 19583 例溃疡性结肠炎[UC]患者）和 150500 名年龄和性别匹配的非 IBD 对照组之间的 HZ 发生率。
在平均 5.0 年的随访期间，CD、UC 和对照组的 HZ（每 1000 人年）发生率分别为 13.60、14.99 和 9.19。与对照组相比，CD（调整后的危险比[HR]，2.13；p<0.001）和 UC（调整后的 HR，1.40；p<0.001）患者发生 HZ 的风险显著更高。CD 对 HZ 发展的影响在年轻患者中更为显著（调整后的 HR，年龄<15 为 2.61，年龄≥60 为 1.39；交互作用 p=0.001），在无代谢合并症的患者中更为显著（调整后的 HR，2.24，而有代谢合并症的患者为 1.59；交互作用 p=0.015）。此外，UC 对 HZ 发展的影响在年轻患者中显著增加（调整后的 HR，年龄<15 为 2.51，年龄≥60 为 1.22；交互作用 p=0.014），在无代谢合并症的患者中也显著增加（调整后的 HR，1.49，而有代谢合并症的患者为 1.16；交互作用 p<0.001）。
IBD 与 HZ 的风险增加相关，尤其是在无代谢合并症的年轻患者中。
