Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China.
Shandong Provincial Clinical Research Center for Digestive Disease, Shandong, China.
Front Immunol. 2024 Apr 24;15:1325908. doi: 10.3389/fimmu.2024.1325908. eCollection 2024.
Previous studies reported possible connections between inflammatory bowel disease (IBD) and several neurodegenerative disorders. However, the comprehensive relationships between IBD and various neurodegenerative disorders were not summarized. We executed a meta-analysis of longitudinal studies to provide an estimate of the strength of the two-directional prospective association between IBD and neurodegenerative disorders.
We accomplished a thorough bibliographic search of PubMed, Web of Science, Embase, PsycINFO, and Cochrane Library databases until June 2023 to locate relevant longitudinal studies. The extracted data were then analyzed via meta-analysis using either a fixed or random effects model.
The final analysis encompassed 27 studies. Individuals with IBD faced an increased risk of developing four neurodegenerative disorders than the general public, namely, Alzheimer's disease (hazard ratio[HR] = 1.35, 95% confidence interval [CI]: 1.03-1.77, P=0.031), dementia (HR =1.24, 95% CI: 1.13-1.36, P<0.001), multiple sclerosis (HR =2.07, 95% CI:1.42-3.02, P<0.001) and Parkinson's disease (HR =1.23, 95% CI:1.10-1.38, P<0.001). Two articles reported an increased incidence of amyotrophic lateral sclerosis or multiple system atrophy in IBD patients. Three studies investigated the prospective association between multiple sclerosis and IBD, revealing an elevated risk of the latter in patients with the former. (HR=1.87, 95% CI:1.66-2.10, P<0.001).
These findings verified the two-directional relationship between the brain-gut axis, specifically demonstrating a heightened risk of various neurodegenerative diseases among IBD patients. It may be profitable to prepare screening strategies for IBD patients to find neurodegenerative diseases during the long-term course of treatment for IBD with a view to potential earlier diagnosis and treatment of neurodegenerative diseases, reducing public health and social burden.
PROSPERO (CRD42023437553).
先前的研究报告称，炎症性肠病（IBD）与几种神经退行性疾病之间可能存在关联。然而，IBD 与各种神经退行性疾病之间的综合关系尚未得到总结。我们对纵向研究进行了荟萃分析，以提供 IBD 和神经退行性疾病之间双向前瞻性关联的强度估计。
我们彻底检索了 PubMed、Web of Science、Embase、PsycINFO 和 Cochrane Library 数据库，直到 2023 年 6 月，以找到相关的纵向研究。然后使用固定或随机效应模型通过荟萃分析分析提取的数据。
最终分析纳入了 27 项研究。与普通人群相比，IBD 患者发生以下四种神经退行性疾病的风险增加，包括阿尔茨海默病（风险比[HR] = 1.35，95%置信区间 [CI]：1.03-1.77，P=0.031）、痴呆症（HR = 1.24，95% CI：1.13-1.36，P<0.001）、多发性硬化症（HR = 2.07，95% CI：1.42-3.02，P<0.001）和帕金森病（HR = 1.23，95% CI：1.10-1.38，P<0.001）。有两篇文章报道了 IBD 患者中肌萎缩侧索硬化症或多系统萎缩症的发病率增加。三项研究调查了多发性硬化症与 IBD 之间的前瞻性关联，结果表明前者患者发生后者的风险升高（HR=1.87，95% CI：1.66-2.10，P<0.001）。
这些发现证实了脑-肠轴之间的双向关系，具体表明 IBD 患者发生各种神经退行性疾病的风险增加。对于 IBD 患者，为了发现神经退行性疾病，可能需要制定筛查策略，以便在 IBD 的长期治疗过程中发现神经退行性疾病，从而实现潜在的早期诊断和治疗，减轻公共卫生和社会负担。
PROSPERO（CRD42023437553）。
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