School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan.
Postgrad Med. 2022 Apr;134(3):290-296. doi: 10.1080/00325481.2022.2041338. Epub 2022 Feb 21.
Ankylosing spondylitis (AS) is a chronic inflammatory disease, might carry a high risk of irritable bowel syndrome (IBS) due to abnormal gut microbiota or inflammatory reaction.
We conducted a 14-year retrospective cohort study based on Taiwan's National Health Insurance Research Database (NHIRD). A total of 4007 patients with newly diagnosed AS (outpatient visits≧3 times, or hospitalization≧1 time) and 988,084 non-AS comparisons were enrolled during 2000-2012. To ensure baseline comparability, the propensity score was matched by age, gender, comorbidities, and other possible confounders. The outcome was the incidence of IBS, followed up to the end of 2013. Cox proportional hazard model calculated adjusted hazard ratio (aHR) and the cumulative incidence of both groups was analyzed by the Kaplan-Meier method.
After propensity score matching, baseline demographic characteristics were comparable between AS patients and the comparison group. The crude HR for IBS in the AS group was significantly higher 2.41 (95%C.I. = 1.84-3.16) than comparison group. After adjusting for possible confounders, adjusted HR was 2.50 (95%C.I. = 1.91-3.29). The cumulative incidence of IBS in AS was significantly higher than non-AS comparisons during the 14-year follow-up (P < 0.001).
This nationwide population-based cohort study showed that patients with AS have higher risks of IBS than those of the non-AS comparison group.
强直性脊柱炎（AS）是一种慢性炎症性疾病，由于肠道微生物群或炎症反应异常，可能存在较高的肠易激综合征（IBS）风险。
我们基于台湾全民健康保险研究数据库（NHIRD）进行了一项为期 14 年的回顾性队列研究。共纳入了 2000 年至 2012 年间 4007 例新诊断为 AS（门诊就诊≧3 次或住院≧1 次）和 988084 例非 AS 对照患者。为了确保基线可比性，采用年龄、性别、合并症和其他可能的混杂因素进行倾向评分匹配。结局为 IBS 的发生率，随访至 2013 年底。Cox 比例风险模型计算调整后的危险比（aHR），并采用 Kaplan-Meier 方法分析两组的累积发病率。
经过倾向评分匹配后，AS 患者和对照组的基线人口统计学特征具有可比性。AS 组的 IBS 粗 HR 明显较高（2.41，95%CI：1.84-3.16）。在调整可能的混杂因素后，调整后的 HR 为 2.50（95%CI：1.91-3.29）。在 14 年的随访期间，AS 患者的 IBS 累积发病率明显高于非 AS 对照组（P<0.001）。
这项基于人群的全国性队列研究表明，与非 AS 对照组相比，AS 患者发生 IBS 的风险更高。
