Nasir Khurram, Acquah Isaac, Dey Amit K, Agrawal Tanushree, Hassan Syed Zawahir, Glassner Kerri, Abraham Bincy, Quigley Eamonn M M, Blankstein Ron, Virani Salim S, Blaha Michael J, Valero-Elizondo Javier, Cainzos-Achirica Miguel, Mehta Nehal N
Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, MD, United States.
Center for Outcomes Research, Houston Methodist Research Institute, Houston, MD, United States.
Am J Prev Cardiol. 2022 Jan 17;9:100316. doi: 10.1016/j.ajpc.2022.100316. eCollection 2022 Mar.
To evaluate the association between inflammatory bowel disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) and whether this association is modified by age or sex.
We conducted a cross-sectional analysis using data from the 2015-2016 National Health Interview Survey (NHIS). The exposure of interest was self-reported IBD. The outcome of interest was prevalent ASCVD, which included a history of angina, myocardial infarction or stroke. We used survey-specific descriptive statistics to obtain weighted national estimates for IBD and ASCVD prevalence. Logistic regression models were used to assess the association between IBD and ASCVD, progressively adjusting for demographics and traditional risk factors. Effect modification by age and sex was evaluated.
Among participants with IBD, the age-adjusted prevalence of ASCVD was 12.0% compared to 6.9% among those without IBD ( < 0.001). In multivariable regression analyses IBD was associated with increased odds of having ASCVD, even after adjustment for demographics and traditional risk factors (odds ratio 1.58, 95% CI 1.17-2.13). We found statistically significant interaction by age ( < 0.001) whereby those in the younger age strata had the strongest association (fully adjusted odds ratio among 18- to 44-year-olds 3.35, 95% CI 1.75, 6.40) while the association was null in those ≥65 years. Effect modification by sex was not observed.
Our analysis confirms an independent association between IBD and ASCVD in the U.S., particularly among young adults. Further studies are needed to fully establish a causal relationship between IBD and ASCVD, characterize the mechanisms underlying these associations, and identify tailored opportunities for ASCVD prevention in young and middle-aged adults with IBD.
评估炎症性肠病（IBD）与动脉粥样硬化性心血管疾病（ASCVD）之间的关联，以及这种关联是否因年龄或性别而有所不同。
我们使用2015 - 2016年国家健康访谈调查（NHIS）的数据进行了横断面分析。感兴趣的暴露因素是自我报告的IBD。感兴趣的结局是ASCVD患病率，包括心绞痛、心肌梗死或中风病史。我们使用特定调查的描述性统计方法来获得IBD和ASCVD患病率的加权全国估计值。采用逻辑回归模型评估IBD与ASCVD之间的关联，并逐步调整人口统计学和传统风险因素。评估年龄和性别对效应的修饰作用。
在患有IBD的参与者中，年龄调整后的ASCVD患病率为12.0%，而在没有IBD的参与者中为6.9%（P<0.001）。在多变量回归分析中，即使在调整了人口统计学和传统风险因素后，IBD仍与ASCVD发生几率增加相关（优势比1.58，95%置信区间1.17 - 2.13）。我们发现年龄存在统计学显著的交互作用（P<0.001），即年龄较小的人群关联最强（18至44岁人群的完全调整优势比为3.35，95%置信区间1.75，6.40），而在65岁及以上人群中这种关联不存在。未观察到性别对效应的修饰作用。
我们的分析证实了在美国IBD与ASCVD之间存在独立关联，尤其是在年轻人中。需要进一步研究以充分确立IBD与ASCVD之间的因果关系，描述这些关联背后的机制，并确定针对患有IBD的中青年进行ASCVD预防的个性化机会。
