Rai Victoria, Traboulsi Cindy, Silfen Alexa, Ackerman Max T, Erondu Amarachi I, Karpin Jordan E, Gulotta George, Rubin David T
University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA.
Crohns Colitis 360. 2021 Jul;3(3). doi: 10.1093/crocol/otab054. Epub 2021 Aug 2.
This study aimed to analyze the association of coexisting sinusitis and IBD, establish significant factors involved in their development, and enable further biological correlation between these two diseases.
he BD and inusitis tudy at Chicago Medicin (TISSUe) is a retrospective, single-center study. We reviewed patients to confirm IBD and chronic sinusitis diagnoses. Case-control propensity score matching was performed using matched controls with IBD only or sinusitis only. Statistical methods included Chi-squared test and Wilcoxon rank sum test. Logistic regression analysis was performed, and factors were considered significant if p<0.05.
Stratifying 214 patients with coexisting IBD and sinusitis, 176 patients had IBD first and 38 patients had sinusitis first. Multivariable analysis of factors associated with subsequent disease with matched controls determined that duration of disease, UC, steroid exposure ever, and younger age of IBD diagnosis were associated with subsequent sinusitis in patients with IBD; steroid exposure ever and duration of sinusitis were significantly associated with subsequent IBD in patients with sinusitis.
This study suggests that IBD maintenance therapies are not associated with increased risk of sinusitis, as proposed by adverse events in clinical trial data; rather, UC diagnosis and duration of disease may be more influential in sinusitis development. While further studies are necessary, this study also demonstrates that sinusitis precedes IBD in some patients, probing its biological association with IBD and possible classification as an extraintestinal manifestation.
本研究旨在分析并存鼻窦炎与炎症性肠病（IBD）之间的关联，确定其发病过程中的重要因素，并进一步探究这两种疾病之间的生物学相关性。
芝加哥医学院的炎症性肠病与鼻窦炎研究（TISSUe）是一项回顾性单中心研究。我们对患者进行了回顾，以确认炎症性肠病和慢性鼻窦炎的诊断。采用仅患有炎症性肠病或仅患有鼻窦炎的匹配对照进行病例对照倾向评分匹配。统计方法包括卡方检验和威尔科克森秩和检验。进行了逻辑回归分析，若p<0.05，则认为因素具有显著性。
对214例并存炎症性肠病和鼻窦炎的患者进行分层，176例患者先患炎症性肠病，38例患者先患鼻窦炎。对与匹配对照的后续疾病相关因素进行多变量分析，结果显示，疾病持续时间、溃疡性结肠炎（UC）、曾使用类固醇以及炎症性肠病诊断时年龄较小与炎症性肠病患者后续发生鼻窦炎相关；曾使用类固醇和鼻窦炎持续时间与鼻窦炎患者后续发生炎症性肠病显著相关。
本研究表明，如临床试验数据中的不良事件所提示的，炎症性肠病维持治疗与鼻窦炎风险增加无关；相反，溃疡性结肠炎诊断和疾病持续时间可能对鼻窦炎的发生更具影响。虽然还需要进一步研究，但本研究也表明，在一些患者中鼻窦炎先于炎症性肠病出现，这进一步探究了其与炎症性肠病的生物学关联以及作为肠外表现进行分类的可能性。
