Li Laifu, Zhuang Yan, Ran Yan, Xu Yaying, Wang Lianli, Chen Lele, Chen Jiamiao, Sun Yating, Mei Lin, Ye Fangchen, Dai Fei
Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Shaanxi Province Key Laboratory of Gastrointestinal Motility Disorders, Xi'an, China.
Department of Endocrinology Department, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, China.
Clin Nutr ESPEN. 2024 Jun;61:212-218. doi: 10.1016/j.clnesp.2024.03.022. Epub 2024 Mar 29.
Inflammatory bowel disease is a common digestive disorder and diabetes can lead to intestinal dysfunction. Patients with inflammatory bowel disease in combination with diabetes present a higher rate of hospitalization and consumption of medical resources, yet the association between type 2 diabetes and Inflammatory bowel disease remains unknown.
We studied 313,008 participants from the UK Biobank, including 5891 patients with type 2 diabetes at baseline. Multivariate Cox proportional risk models were constructed to examine the risks associated with type 2 diabetes and inflammatory bowel disease and its subtypes (Crohn's disease, ulcerative colitis). Potential confounders including sociodemographic, lifestyle, physical body indicators, psychological state, hypertension, and thyroid-related disorders were adjusted. Propensity score matching was also performed to analyze their sensitivity.
Of a total of 313,008 participants included in the study, 5891 (1.88 %) were diagnosed with type 2 diabetes mellitus at baseline and 1829 (0.58 %) of the entire cohort developed inflammatory bowel disease during follow-up, with a median follow-up time of 13.72 years. Patients with type 2 diabetes had a higher cumulative risk of inflammatory bowel disease compared to the non-type 2 diabetes population (inflammatory bowel disease: 1.24% vs. 0.57%, p < 0.001; Crohn's disease: 0.46% vs. 0.15%, p < 0.001; ulcerative colitis: 0.73% vs. 0.35%, p < 0.001). Multivariate Cox regression analysis showed that type 2 diabetes was independently associated with inflammatory bowel disease (Hazard Ratio: 1.61 [95% Confidence Interval: 1.26-2.06], p < 0.001), Crohn's disease (Hazard Ratio: 2.10 [95% Confidence Interval: 1.39-3.17], p < 0.001) and ulcerative colitis (Hazard Ratio: 1.58 [95% Confidence Interval: 1.15-2.18], p = 0.005). In a propensity-matched analysis, type 2 diabetes still showed its ability to predict the risk of inflammatory bowel disease (Hazard Ratio: 2.09 [95% Confidence Interval: 1.55-2.83], p < 0.001), Crohn's disease (Hazard Ratio: 3.49 [95% Confidence Interval: 2.00 to 6.09], p < 0.001), and ulcerative colitis (Hazard Ratio: 1.76 [95% Confidence Interval: 1.20 to 2.56], p = 0.003) of robustness.
In patients with type 2 diabetes mellitus, the risk of inflammatory bowel disease is higher, and the presence of gastrointestinal symptoms in patients with type 2 diabetes requires vigilance for the possibility of inflammatory bowel disease in clinical practice.
炎症性肠病是一种常见的消化系统疾病，糖尿病可导致肠道功能障碍。炎症性肠病合并糖尿病的患者住院率和医疗资源消耗率更高，但2型糖尿病与炎症性肠病之间的关联尚不清楚。
我们研究了来自英国生物银行的313,008名参与者，其中包括基线时的5891名2型糖尿病患者。构建多变量Cox比例风险模型，以检验与2型糖尿病和炎症性肠病及其亚型（克罗恩病、溃疡性结肠炎）相关的风险。对包括社会人口统计学、生活方式、身体指标、心理状态、高血压和甲状腺相关疾病在内的潜在混杂因素进行了调整。还进行了倾向得分匹配以分析其敏感性。
在纳入研究的313,008名参与者中，5891名（1.88%）在基线时被诊断为2型糖尿病，在整个队列中，1829名（0.58%）在随访期间发生了炎症性肠病，中位随访时间为13.72年。与非2型糖尿病人群相比，2型糖尿病患者发生炎症性肠病的累积风险更高（炎症性肠病：1.24%对0.57%，p<0.001；克罗恩病：0.46%对0.15%，p<0.001；溃疡性结肠炎：0.73%对0.35%，p<0.001）。多变量Cox回归分析显示，2型糖尿病与炎症性肠病（风险比：1.61[95%置信区间：1.26 - 2.06]，p<0.001）、克罗恩病（风险比：2.10[95%置信区间：1.39 - 3.17]，p<0.001）和溃疡性结肠炎（风险比：1.58[95%置信区间：1.15 - 2.18]，p = 0.005）独立相关。在倾向得分匹配分析中，2型糖尿病仍显示出预测炎症性肠病（风险比：2.09[95%置信区间：1.55 - 2.83]，p<0.001）、克罗恩病（风险比：3.49[95%置信区间：2.00至6.09]，p<0.001）和溃疡性结肠炎（风险比：1.76[95%置信区间：1.20至2.56]，p = 0.003）风险的稳健性。
在2型糖尿病患者中，炎症性肠病的风险更高，2型糖尿病患者出现胃肠道症状在临床实践中需要警惕炎症性肠病的可能性。
