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肠易激综合征与帕金森病风险:基于登记处的研究

Irritable bowel syndrome and Parkinson's disease risk: register-based studies.

作者信息

Liu Bojing, Sjölander Arvid, Pedersen Nancy L, Ludvigsson Jonas F, Chen Honglei, Fang Fang, Wirdefeldt Karin

机构信息

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Department of Psychology, University of Southern California, Los Angeles, CA, USA.

出版信息

NPJ Parkinsons Dis. 2021 Jan 5;7(1):5. doi: 10.1038/s41531-020-00145-8.

Abstract

To examine whether irritable bowel syndrome (IBS) was related to the future risk of Parkinson's disease (PD), we conducted a nested case-control study in the Swedish total population including 56,564 PD cases identified from the Swedish Patient Register and 30 controls per case individually matched by sex and year of birth. Odds ratios (ORs) with 95% confidence intervals (CIs) for having a prior diagnosis of IBS were estimated using conditional logistic regression. We furthermore conducted a cohort study using the Swedish Twin Registry following 3046 IBS patients identified by self-reported abdominal symptoms and 41,179 non-IBS individuals. Through Cox proportional hazard models, we estimated hazard ratios (HRs) and 95% CIs for PD risk. In the nested case-control study, 253 (0.4%) PD cases and 5204 (0.3%) controls had a previous IBS diagnosis. IBS diagnosis was associated with a 44% higher risk of PD (OR = 1.44, 95% CI 1.27-1.63). Temporal relationship analyses showed 53% and 38% increased risk of PD more than 5 and 10 years after IBS diagnosis, respectively. In the cohort analysis based on the Swedish Twin Registry, there was no statistically significantly increased risk of PD related to IBS (HR = 1.25, 95% CI = 0.87-1.81). Our results suggest a higher risk of PD diagnosis after IBS. These results provide additional evidence supporting the importance of the gut-brain axis in PD.

摘要

为了研究肠易激综合征(IBS)是否与帕金森病(PD)的未来发病风险相关,我们在瑞典总人口中开展了一项巢式病例对照研究,该研究纳入了从瑞典患者登记册中识别出的56564例PD病例,并为每例病例分别匹配30名按性别和出生年份匹配的对照。使用条件逻辑回归估计IBS既往诊断的比值比(OR)及其95%置信区间(CI)。我们还利用瑞典双胞胎登记册开展了一项队列研究,随访了3046例通过自我报告的腹部症状识别出的IBS患者和41179例非IBS个体。通过Cox比例风险模型,我们估计了PD风险的风险比(HR)及其95%CI。在巢式病例对照研究中,253例(0.4%)PD病例和5204例(0.3%)对照有IBS既往诊断。IBS诊断与PD风险升高44%相关(OR = 1.44,95%CI 1.27 - 1.63)。时间关系分析显示,IBS诊断后5年以上和10年以上PD风险分别增加53%和38%。在基于瑞典双胞胎登记册的队列分析中,与IBS相关的PD风险没有统计学上的显著增加(HR = 1.25,95%CI = 0.87 - 1.81)。我们的结果表明IBS后PD诊断风险更高。这些结果提供了额外的证据,支持了肠-脑轴在PD中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c02/7785733/1f9dd6f69111/41531_2020_145_Fig1_HTML.jpg

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