Vestfold Hospital Trust, Tønsberg, Norway.
Centre for Fertility and Health, The Norwegian Institute of Public Health, Oslo, Norway.
BMC Gastroenterol. 2022 May 28;22(1):266. doi: 10.1186/s12876-022-02340-8.
BACKGROUND AND AIMS: Poor quality of life is a main complaint among individuals with irritable bowel syndrome (IBS). Self-rated health (SRH) is a powerful predictor of clinical outcomes, and also reflects psychological and social aspects of life and an overall sense of well-being. This population-based twin study evaluates how IBS affects ratings of physical and mental health, and influences perceptions of hindrance of daily activity by physical or mental health. Further, we examine how IBS is related to these SRH measures. METHODS: The sample included 5288 Norwegian twins aged 40-80, of whom 575 (10.9%) suffer from IBS. Hierarchical regressions were used to estimate the impact of IBS on perceptions of health, before and after accounting for other chronic physical and mental health conditions. Two dimensions of SRH, physical and mental, and two aspects of functional limitations, the extent to which physical or mental health interferes with daily activities, were included as outcomes in separate models. Co-twin control analyses were used to explore whether the relationships between IBS and the four measures of SRH are causal, or due to shared genetic or shared environment effects. RESULTS: IBS was an independent predictor of poor self-rated physical health (OR = 1.82 [1.41; 2.33]), the size of this effect was comparable to that predicted by chronic somatic conditions. However, in contrast to somatic diseases, IBS was associated with the perception that poorer ratings of mental health (OR = 1.45 [1.02; 2.06]), but not physical health (OR = 1.23 [0.96; 1.58]), interfered with daily activity. The co-twin control analyses suggest that causal mechanisms best explain the relationships between IBS with self-rated physical health and with hindrance of daily activities. In contrast, the relationship between IBS and self-rated mental health was consistent with shared genetic effects. CONCLUSION: IBS is predictive of poor self-rated physical health. The relationship between IBS and self-rated mental health is best explained by shared genetic effects which might partially explain why mental health interferes with daily activity to a larger degree among those with IBS.
背景和目的：生活质量差是肠易激综合征（IBS）患者的主要抱怨之一。自我评估健康（SRH）是临床结果的有力预测指标，它还反映了生活的心理和社会方面以及整体幸福感。本项基于人群的双胞胎研究评估了 IBS 如何影响身体和心理健康的评分，并影响身体或心理健康对日常活动的障碍的感知。此外，我们还研究了 IBS 与这些 SRH 测量值的关系。
方法：该样本包括 5288 名年龄在 40-80 岁的挪威双胞胎，其中 575 名（10.9%）患有 IBS。使用分层回归来估计 IBS 对健康感知的影响，在考虑其他慢性身体和心理健康状况之前和之后进行评估。SRH 的两个维度，身体和精神，以及功能限制的两个方面，即身体或心理健康对日常活动的干扰程度，作为单独模型中的结果包括在内。同卵双胞胎对照分析用于探讨 IBS 与 SRH 的四个测量值之间的关系是因果关系，还是由于共同的遗传或共同的环境影响所致。
结果：IBS 是自我评估的身体不健康的独立预测因素（OR=1.82[1.41；2.33]），这种影响的大小与慢性躯体疾病的预测相当。然而，与躯体疾病不同，IBS 与较差的心理健康评分感知有关（OR=1.45[1.02；2.06]），但与身体健康评分无关（OR=1.23[0.96；1.58]），会干扰日常活动。同卵双胞胎对照分析表明，因果机制最好地解释了 IBS 与自我评估的身体健康和日常活动障碍之间的关系。相比之下，IBS 与自我评估的心理健康之间的关系与共同遗传效应一致。
结论：IBS 可预测自我评估的身体健康状况不佳。IBS 与自我评估的心理健康之间的关系最好用共同的遗传效应来解释，这可能部分解释了为什么心理健康在患有 IBS 的人群中对日常活动的干扰程度更大。
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