Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Xicheng District, Beijing 100088, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China.
J Affect Disord. 2024 Jan 15;345:419-426. doi: 10.1016/j.jad.2023.10.111. Epub 2023 Oct 16.
To examine the association between depression and the risk of incident irritable bowel syndrome (IBS).
We included 98,564 participants free of IBS in the UK biobank. Depression was defined by self-report and Hospital Episode Statistics. The main outcome was incident IBS. Cox proportional hazards regression models and two-sample mendelian randomization were performed to estimate the risk of incident IBS.
Among 98,564 participants, 8770 (8.9 %) participants had a depression diagnosis at baseline. During a median of 12.9-year follow-up, 224 cases of incident IBS were identified in patients with depression (2.0 per 1000 person-years), compared with 1625 cases in reference individuals (1.5 per 1000 person-years). After adjustment, the hazard ratio of incident IBS associated with depression was 1.26 (95 % CI: 1.01-1.41). Sensitivity analysis indicated similar results. The two-sample mendelian randomization based on the inverse variance weighted method provided evidence for the harmful role of depression in an increased risk of IBS with an OR of 1.57 (95 % CI: 1.24-1.99).
Depression was mainly measured by self-report online CIDI-SF in the current study, rather than the gold diagnostic criteria including clinical structured interview, which might lead to potential measurement error. Lifestyle behaviors might change during the long-term follow-up, and time-varying covariates (i.e., smoking and alcohol status) may bias the estimate.
Depression is associated with an increased risk of incident IBS. Further studies are warranted to confirm the role of depression on incident IBS and elucidate the underlying mechanisms.
研究抑郁与肠易激综合征（IBS）发病风险的相关性。
我们纳入了英国生物银行中 98564 名无 IBS 病史的参与者。抑郁通过自我报告和住院统计数据来定义。主要结局是 IBS 的发病情况。采用 Cox 比例风险回归模型和双样本 Mendelian 随机化来评估 IBS 发病的风险。
在 98564 名参与者中，8770 名（8.9%）参与者在基线时被诊断患有抑郁。在中位 12.9 年的随访期间，在患有抑郁的患者中发现了 224 例 IBS 发病病例（每 1000 人年 2.0 例），而在参考个体中则发现了 1625 例（每 1000 人年 1.5 例）。调整后，抑郁与 IBS 发病相关的风险比为 1.26（95%CI：1.01-1.41）。敏感性分析表明结果相似。基于逆方差加权法的双样本 Mendelian 随机化提供了证据，表明抑郁与 IBS 发病风险增加有关，OR 为 1.57（95%CI：1.24-1.99）。
本研究中，抑郁主要通过在线 CIDI-SF 进行自我报告测量，而非包括临床结构化访谈在内的金标准诊断，这可能导致潜在的测量误差。在长期随访期间，生活方式行为可能会发生变化，时变协变量（如吸烟和饮酒状况）可能会对估计值产生偏差。
抑郁与 IBS 的发病风险增加有关。需要进一步的研究来证实抑郁对 IBS 发病的作用，并阐明其潜在机制。
