Department of Gastroenterology, Medical College of Georgia/Augusta University, Augusta, GA, USA.
Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.
Korean J Gastroenterol. 2020 Oct 25;76(4):185-190. doi: 10.4166/kjg.2020.76.4.185.
BACKGROUND/AIMS: Inflammatory bowel disease (IBD) is a complex condition precipitated by genetic susceptibility and possibly a disturbed microbiome. The role of dairy foods in IBD is controversial. This study examined the association between lactose intolerance (LI) and IBD.
Data on hospital admissions of all IBD adult patients were extracted from the National Inpatient Sample database between 2004 and 2014. The comorbidities and outcomes of interest were defined by querying all the diagnostic and procedural fields for the corresponding International Classification of Diseases 9th version (ICD-9) codes. Patients with IBD were defined as the "study group," and the patients who did not have IBD were defined as the "control group". LI was identified in both groups using the ICD-9 codes. Multivariate logistic regression was performed to examine the association between IBD and LI.
The total population was 71,342,237 patients, of which 598,129 (0.83%) had IBD. The IBD patients were younger (52 years vs. 57 years) and with fewer females (57.5% vs. 60.1%) (p<0.001 for all). After adjusting for the potential confounding factors, the IBD group had a significantly higher rate of LI (OR 2.71, 95% CI 2.55-2.88, p<0.001) compared to the non-IBD group. The findings were similar on the further stratification of IBD into Crohn's disease compared to the control group (OR 2.70, 95% CI 2.50-2.92, p<0.001) and ulcerative colitis compared to the control group (OR 2.71, 95% CI 2.46-2.98, p<0.001).
IBD patients have a 2.7 times higher risk of LI. Screening for LI in this population is warranted to avoid confusing or overlapping symptomatology.
背景/目的：炎症性肠病（IBD）是一种由遗传易感性和可能的微生物失调引发的复杂疾病。乳制品在 IBD 中的作用存在争议。本研究旨在研究乳糖不耐受（LI）与 IBD 之间的关联。
从 2004 年至 2014 年，从国家住院患者样本数据库中提取了所有 IBD 成年患者的住院数据。通过查询相应的国际疾病分类第 9 版（ICD-9）代码的所有诊断和程序字段，定义了感兴趣的合并症和结局。将 IBD 患者定义为“研究组”，未患 IBD 的患者定义为“对照组”。使用 ICD-9 代码在两组中均确定 LI。使用多变量逻辑回归检查 IBD 与 LI 之间的关联。
总人群为 71342237 人，其中 598129 人（0.83%）患有 IBD。IBD 患者年龄较小（52 岁 vs. 57 岁），女性比例较少（57.5% vs. 60.1%）（均<0.001）。在调整了潜在的混杂因素后，与非 IBD 组相比，IBD 组的 LI 发生率明显更高（OR 2.71，95%CI 2.55-2.88，p<0.001）。在将 IBD 进一步细分为克罗恩病与对照组相比（OR 2.70，95%CI 2.50-2.92，p<0.001）和溃疡性结肠炎与对照组相比（OR 2.71，95%CI 2.46-2.98，p<0.001）时，发现结果相似。
IBD 患者发生 LI 的风险高 2.7 倍。在该人群中筛查 LI 是合理的，以避免混淆或重叠的症状。
