Lee Il Hwan, Ha Seung-Su, Son Gil Myeong, Yang Hee Gyu, Kim Dong-Kyu
Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Korea.
Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24252, Korea.
Diagnostics (Basel). 2022 Sep 28;12(10):2344. doi: 10.3390/diagnostics12102344.
Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease of the sinonasal mucosa with an inflammatory or infectious etiology. Inflammatory bowel disease (IBD) causes chronic intestinal inflammation. Thus, both diseases share innate immune and epithelial barrier dysfunctions of the mucosa. However, the association between sinusitis and IBD is not well-known. We aimed to determine the association between CRS and the risk for IBDs, such as Crohn's disease (CD) and ulcerative colitis (UC). In this long-term retrospective cohort study, 15,175 patients with CRS and 30,350 patients without CRS (comparison group) were enrolled after 1:2 propensity score matching. The incidence rates of CD and UC were 0.22 and 0.51 (1000 person-years), respectively. The adjusted hazard ratio (HR) for developing CD and UC in CRS patients was 1.01 (95% confidence interval (CI), 0.66-1.54) and 1.72 (95% CI, 1.26-2.36), respectively. Additionally, in the subgroup analysis using the CRS phenotype, the adjusted HRs of UC were significantly increased in patients with CRS without nasal polyps (adjusted HR = 1.71; 95% CI, 1.24-2.35), but not in those with CRS with nasal polyps. CRS without nasal polyps is associated with an increased incidence of UC but not CD. Therefore, clinicians should pay attention to the early detection of UC when treating patients with CRS without nasal polyps.
慢性鼻-鼻窦炎（CRS）是一种常见的鼻窦黏膜慢性炎症性疾病，病因是炎症或感染。炎症性肠病（IBD）会导致慢性肠道炎症。因此，这两种疾病都存在黏膜先天性免疫和上皮屏障功能障碍。然而，鼻窦炎与IBD之间的关联尚不为人所知。我们旨在确定CRS与IBD（如克罗恩病（CD）和溃疡性结肠炎（UC））风险之间的关联。在这项长期回顾性队列研究中，15175例CRS患者和30350例无CRS患者（对照组）在进行1:2倾向评分匹配后入组。CD和UC的发病率分别为0.22和0.51（每1000人年）。CRS患者发生CD和UC的校正风险比（HR）分别为1.01（95%置信区间（CI），0.66 - 1.54）和1.72（95%CI，1.26 - 2.36）。此外，在使用CRS表型的亚组分析中，无鼻息肉的CRS患者中UC的校正HR显著升高（校正HR = 1.71；95%CI，1.24 - 2.35），但有鼻息肉的CRS患者中未升高。无鼻息肉的CRS与UC发病率增加相关，但与CD无关。因此，临床医生在治疗无鼻息肉的CRS患者时应注意UC的早期检测。
