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炎症性肠病与多发性硬化症发病率增加相关:一项对 24934 名患者的回顾性队列研究。

Inflammatory bowel disease is associated with an increase in the incidence of multiple sclerosis: a retrospective cohort study of 24,934 patients.

机构信息

Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.

Epidemiology, IQVIA, Frankfurt, Germany.

出版信息

Eur J Med Res. 2024 Mar 20;29(1):186. doi: 10.1186/s40001-024-01776-w.

Abstract

BACKGROUND

Recent data suggest a potential pathophysiological link between inflammatory bowel disease (IBD) and multiple sclerosis (MS), two immune-mediated diseases both of which can have a significant impact on patients' quality of life. In the present manuscript, we investigate the association between IBD and MS in a German cohort of general practice patients. These results may have important implications for the screening and management of patients with IBD, as well as for further research into the pathophysiological mechanisms underlying both disorders.

METHODS

4,934 individuals with IBD (11,140 with Crohn's disease (CD) and 13,794 with ulcerative colitis (UC)) as well as 24,934 propensity score matched individuals without IBD were identified from the Disease Analyzer database (IQVIA). A subsequent diagnosis of MS was analyzed as a function of IBD using Cox regression models.

RESULTS

After 10 years of follow-up, 0.9% and 0.7% of CD and UC patients but only 0.5% and 0.3% of matched non-IBD pairs were diagnosed with MS, respectively (p = 0.002 and p < 0.001). Both CD (HR: 2.09; 95% CI 1.28-3.39) and UC (HR: 2.35; 95% CI 1.47-3.78) were significantly associated with a subsequent MS diagnosis. Subgroup analysis revealed that the association between both CD and UC and MS was more pronounced among male patients.

CONCLUSION

The results of our analysis suggest a notable association between IBD and a subsequent MS diagnosis. These findings warrant further pathophysiological investigation and may have clinical implications for the screening of IBD patients in the future.

摘要

背景

最近的数据表明,炎症性肠病(IBD)和多发性硬化症(MS)这两种免疫介导的疾病之间可能存在潜在的病理生理学联系,这两种疾病都会对患者的生活质量产生重大影响。在本手稿中,我们在德国的普通实践患者队列中研究了 IBD 和 MS 之间的关联。这些结果可能对 IBD 患者的筛查和管理具有重要意义,也为进一步研究这两种疾病的病理生理机制提供了依据。

方法

从 IQVIA 的 Disease Analyzer 数据库中确定了 4934 名 IBD 患者(11140 名克罗恩病(CD)患者和 13794 名溃疡性结肠炎(UC)患者)和 24934 名匹配的无 IBD 个体。使用 Cox 回归模型分析随后的 MS 诊断作为 IBD 的函数。

结果

在 10 年的随访后,0.9%和 0.7%的 CD 和 UC 患者被诊断为 MS,而仅 0.5%和 0.3%的匹配非 IBD 对被诊断为 MS(p=0.002 和 p<0.001)。CD(HR:2.09;95%CI 1.28-3.39)和 UC(HR:2.35;95%CI 1.47-3.78)均与随后的 MS 诊断显著相关。亚组分析显示,CD 和 UC 与 MS 之间的关联在男性患者中更为明显。

结论

我们的分析结果表明,IBD 与随后的 MS 诊断之间存在显著关联。这些发现需要进一步进行病理生理学研究,并且可能对未来 IBD 患者的筛查具有临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e439/10953134/683c869182cc/40001_2024_1776_Fig1_HTML.jpg

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