Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea.
J Gastroenterol Hepatol. 2020 Feb;35(2):249-255. doi: 10.1111/jgh.14838. Epub 2019 Sep 16.
The relationship between inflammatory bowel disease (IBD) and idiopathic pulmonary fibrosis (IPF) remains unclear. We evaluated the risk for developing IPF in patients with IBD using a nationwide population-based study.
Using claims data from the National Health Insurance service in Korea, patients with IBD, including Crohn's disease (CD) and ulcerative colitis (UC), were identified through both the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and rare and intractable disease program codes from January 2010 to December 2013. We compared 38 921 IBD patients with age-matched and sex-matched individuals without IBD in a ratio of 1:3. Patients with newly diagnosed IPF were identified by both the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and rare and intractable disease registration codes.
During a mean 4.9-year follow-up, the incidence of IPF in patients with IBD was 33.21 per 100 000 person-years. The overall risk of IPF was significantly higher in IBD patients than in non-IBD controls (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.20-2.20; P = 0.003). In patients with CD, the incidence (per 100 000 person-years) of IPF was 26.04; in controls, the incidence was 9.15 (HR, 2.89; 95% CI, 1.46-5.72; P = 0.002). The incidence of IPF in patients with UC tended to be higher than in controls (36.66 vs 26.54 per 100 000 person-years; 95% CI, 0.99-1.99; HR, 1.41; P = 0.066). The risk of developing IPF in patients with IBD was higher in male patients than in female patients (P = 0.093 in CD; P = 0.147 in UC by interaction analysis).
Patients with IBD, especially CD, have an increased risk of developing IPF.
炎症性肠病（IBD）与特发性肺纤维化（IPF）之间的关系仍不清楚。我们通过一项全国性基于人群的研究，评估了 IBD 患者发生 IPF 的风险。
使用来自韩国国民健康保险服务的索赔数据，通过国际疾病分类第 10 版和罕见及难治性疾病计划代码，从 2010 年 1 月至 2013 年 12 月，确定 IBD 患者，包括克罗恩病（CD）和溃疡性结肠炎（UC）。我们将 38921 例 IBD 患者与年龄和性别匹配的无 IBD 个体按 1:3 的比例进行比较。通过国际疾病分类第 10 版和罕见及难治性疾病登记代码，确定新诊断为 IPF 的患者。
在平均 4.9 年的随访期间，IBD 患者的 IPF 发病率为 33.21/10 万人年。与非 IBD 对照组相比，IBD 患者发生 IPF 的总体风险显著更高（风险比[HR]，1.62；95%置信区间[CI]，1.20-2.20；P=0.003）。在 CD 患者中，IPF 的发病率（每 10 万人年）为 26.04，而对照组为 9.15（HR，2.89；95%CI，1.46-5.72；P=0.002）。UC 患者的 IPF 发病率高于对照组（每 10 万人年 36.66 例 vs 26.54 例；95%CI，0.99-1.99；HR，1.41；P=0.066）。与女性患者相比，IBD 患者（CD 中 P=0.093；UC 中 P=0.147，交互分析）发生 IPF 的风险更高。
IBD 患者，尤其是 CD 患者，发生 IPF 的风险增加。
