Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
University of Manitoba IBD Clinical and Research Centre, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Inflamm Bowel Dis. 2023 Jul 5;29(7):1073-1079. doi: 10.1093/ibd/izac184.
This study aimed to determine whether having a diagnosis of asthma or allergic rhinitis (AR) increased the risk of being diagnosed with inflammatory bowel disease (IBD) and whether there was increased incidence of these diseases after a diagnosis of IBD.
This is a retrospective, historical cohort-based study. We used the administrative data of Manitoba Health and the population-based University of Manitoba IBD Epidemiology Database. We used numbers of prescriptions for drugs used to treat asthma and to treat AR to identify diagnoses of asthma and AR, respectively.We calculated relative risks (RRs) to assess incidence of IBD compared with matched controls after diagnoses of asthma and AR and hazard ratios to determine the incidence of asthma and AR after IBD diagnosis.
Compared with controls, a diagnosis of asthma or AR preceding a diagnosis of IBD was increased in cases (RR, 1.62; 95% confidence interval [CI], 1.50-1.75; and RR, 2.10; 95% CI, 1.97-2.24) with a similar outcome by subtype of IBD (Crohn's disease vs ulcerative colitis) and by sex. On sensitivity analysis, diagnoses of asthma or AR were comparable when considering at least 5, 10, 15 or 20 drug prescriptions. Persons with IBD were more likely to develop asthma or AR than controls after being diagnosed with IBD (hazard ratio for asthma, 1.31, 95% CI, 1.18-1.45; and hazard ratio for AR, 2.62, 95% CI, 2.45-2.80).
The association between asthma, AR, and IBD suggest the possibility that whatever triggers the onset of these atopic diseases may trigger the onset of IBD as well, and aeroallergens are plausible culprits.
本研究旨在确定哮喘或过敏性鼻炎（AR）的诊断是否会增加炎症性肠病（IBD）的发病风险，以及在诊断为 IBD 后这些疾病的发病率是否会增加。
这是一项回顾性、基于历史队列的研究。我们使用了马尼托巴省卫生署的行政数据和基于人群的马尼托巴大学 IBD 流行病学数据库。我们使用治疗哮喘和治疗 AR 的药物处方数量来分别确定哮喘和 AR 的诊断。我们计算了相对风险（RR），以评估在诊断为哮喘和 AR 后与匹配对照相比 IBD 的发病率，并计算了风险比（HR），以确定在诊断为 IBD 后哮喘和 AR 的发病率。
与对照组相比，在患有 IBD 的病例中，哮喘或 AR 的诊断先于 IBD 的诊断（RR，1.62；95%置信区间[CI]，1.50-1.75；RR，2.10；95%CI，1.97-2.24），并且在 IBD 的亚型（克罗恩病与溃疡性结肠炎）和性别方面也有类似的结果。在敏感性分析中，当考虑至少 5、10、15 或 20 个药物处方时，哮喘或 AR 的诊断是可比的。与对照组相比，诊断为 IBD 后的患者发生哮喘或 AR 的可能性高于对照组（哮喘的 HR，1.31，95%CI，1.18-1.45；AR 的 HR，2.62，95%CI，2.45-2.80）。
哮喘、AR 和 IBD 之间的关联表明，引发这些特应性疾病的任何因素都可能引发 IBD，而空气过敏原可能是罪魁祸首。
