Division of Neurology, Department of Internal medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.
Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan.
PLoS One. 2019 Aug 1;14(8):e0220641. doi: 10.1371/journal.pone.0220641. eCollection 2019.
Previous research has suggested an association between antidepressants use and clinical restless legs syndrome (RLS) in patients, but there has never been a single study investigating the risk of RLS in irritable bowel syndrome (IBS) patients treated with antidepressants. Hence, we aimed to explore the association between IBS and RLS and to examine the risk of RLS in IBS patients treated with antidepressants. With the use of the National Health Insurance Research Database of Taiwan, 27,437 adults aged ≥ 20 years with newly diagnosed IBS (ICD-9-CM Code 564.1) and gender- and age-matched 54,874 controls without IBS were enrolled between 2000 and 2012. All patients were followed-up until RLS diagnosis, withdrawal from the National Health Insurance program, or end of 2013. We used the Cox proportional hazards model to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of RLS. RLS was more prevalent in IBS patients than in the non-IBS group (7.57 versus 3.36 per 10,000 person-years), with an increased risk of RLS (adjusted HR [aHR], 1.91; 95% CI, 1.52-2.40). Multivariate Cox proportional hazards analysis identified older age (age, 51-65 years; aHR, 1.67; 95% CI, 1.09-2.56; and age > 65; aHR, 1.59; 95% CI, 1.02-2.48), hypothyroidism (aHR, 4.24; 95% CI, 1.92-9.37), CAD (aHR, 1.70; 95% CI, 1.17-2.48), and depression (aHR, 3.15; 95% CI, 2.14-4.64) as independent RLS risk factors in IBS patients. In addition, the male SSRIs users were associated with significantly higher risk of RLS (aHR, 3.05 95% CI, 1.34-6.92). Our study showed that the IBS group has higher risk of RLS. Moreover, SSRIs use may increase the risk of RLS in male IBS patients.
先前的研究表明，抗抑郁药的使用与患者的临床不安腿综合征（RLS）之间存在关联，但从未有过单一研究调查接受抗抑郁药治疗的肠易激综合征（IBS）患者中 RLS 的风险。因此，我们旨在探讨 IBS 与 RLS 之间的关联，并研究接受抗抑郁药治疗的 IBS 患者中 RLS 的风险。利用台湾全民健康保险研究数据库，2000 年至 2012 年间，共纳入 27437 名年龄≥20 岁的新诊断为 IBS（ICD-9-CM 代码 564.1）的成年人和性别及年龄匹配的 54874 名无 IBS 的对照组。所有患者均随访至 RLS 诊断、退出全民健康保险计划或 2013 年底。我们使用 Cox 比例风险模型计算 RLS 的风险比（HR）和 95%置信区间（CI）。与非 IBS 组相比，IBS 患者中 RLS 的患病率更高（每 10000 人年 7.57 例与 3.36 例），RLS 的风险增加（调整后的 HR[aHR]，1.91；95%CI，1.52-2.40）。多变量 Cox 比例风险分析确定了年龄较大（年龄 51-65 岁；aHR，1.67；95%CI，1.09-2.56；年龄>65 岁；aHR，1.59；95%CI，1.02-2.48）、甲状腺功能减退症（aHR，4.24；95%CI，1.92-9.37）、CAD（aHR，1.70；95%CI，1.17-2.48）和抑郁症（aHR，3.15；95%CI，2.14-4.64）是 IBS 患者 RLS 的独立危险因素。此外，男性 SSRIs 使用者患 RLS 的风险显著增加（aHR，3.05；95%CI，1.34-6.92）。我们的研究表明，IBS 组患 RLS 的风险更高。此外，SSRIs 的使用可能会增加男性 IBS 患者患 RLS 的风险。
