Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Ann Clin Transl Neurol. 2022 Feb;9(2):132-140. doi: 10.1002/acn3.51495. Epub 2022 Jan 29.
BACKGROUND: Multiple sclerosis (MS) and inflammatory bowel disease (IBD) are two autoimmune diseases that seriously affect patients' quality of life. Previous studies have established an association between MS and IBD, including Crohn's disease (CD) and ulcerative colitis (UC), but the results were inconsistent. The aim of this study was to quantify the prevalences of and the association between MS and IBD. METHODS: The PubMed, Web of Science, and Embase databases were searched through November 2020 for studies reporting data on MS among patients with IBD and vice versa. The main outcomes were the proportion of MS in patients with IBD and vice versa, as well as the association (risk ratio [RR]) of IBD in MS and that of MS in IBD. RESULTS: Based on the analysis of 17 studies, the prevalence of MS in patients with IBD was 0.2% (95% CI 0.1-0.4%), while the prevalence of IBD in patients with MS was 0.6% (95% CI 0.4-0.9%). Patients with MS had a higher prevalence of IBD than controls (RR = 1.53, 95% CI 1.38-1.70, p < 0.00001). There was a similarly high risk of developing CD (RR 1.41, 95% CI 1.14-1.74, p = 0.001) or UC (RR 1.42, 95% CI 1.17-1.71, p = 0.0003) in patients with MS (p for subgroup differences: 0.97). Patients with IBD had a higher prevalence of MS than controls (RR = 1.91, 95% CI 1.06-3.45, p = 0.03). CONCLUSIONS: Clinicians should be aware of the increased risk of IBD or MS comorbidity during the diagnostic process. Systematic diagnosis and management at an earlier stage are suggested.
背景：多发性硬化症（MS）和炎症性肠病（IBD）是两种严重影响患者生活质量的自身免疫性疾病。先前的研究已经确定了 MS 与 IBD（包括克罗恩病（CD）和溃疡性结肠炎（UC））之间的关联，但结果并不一致。本研究的目的是量化 MS 和 IBD 之间的患病率和关联。
方法：通过检索 PubMed、Web of Science 和 Embase 数据库，检索了截至 2020 年 11 月报告 IBD 患者中 MS 数据和反之亦然的研究。主要结局是 IBD 患者和反之亦然的 MS 比例，以及 MS 患者的 IBD 关联（风险比 [RR]）和 IBD 患者的 MS 关联。
结果：基于对 17 项研究的分析，IBD 患者的 MS 患病率为 0.2%（95% CI 0.1-0.4%），而 MS 患者的 IBD 患病率为 0.6%（95% CI 0.4-0.9%）。与对照组相比，MS 患者的 IBD 患病率更高（RR=1.53，95% CI 1.38-1.70，p<0.00001）。MS 患者发生 CD（RR 1.41，95% CI 1.14-1.74，p=0.001）或 UC（RR 1.42，95% CI 1.17-1.71，p=0.0003）的风险也同样较高（亚组间差异的 p 值：0.97）。与对照组相比，IBD 患者的 MS 患病率更高（RR=1.91，95% CI 1.06-3.45，p=0.03）。
结论：临床医生在诊断过程中应意识到 IBD 或 MS 合并症的风险增加。建议早期进行系统诊断和管理。
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