Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Clinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Aliment Pharmacol Ther. 2024 Oct;60(7):934-939. doi: 10.1111/apt.18197. Epub 2024 Aug 5.
Irritable bowel syndrome (IBS) is common among individuals with eating disorders. The relationship between these conditions is likely bidirectional. However, data on the risk of IBS among those with prior eating disorders is largely limited to cross-sectional studies.
To prospectively evaluate the association between maladaptive weight control/eating behaviours in females during adolescence/young adulthood with subsequent IBS using the Growing Up Today Study (GUTS).
Starting in 1996 (age: 9-14) and during follow-up, participants reported frequency of maladaptive eating/weight control behaviours during the past year to lose weight: self-induced vomiting (n = 5740), laxative use (n = 5438), and fasting (n = 5522) in addition to reporting binge eating (n = 4459). Starting in 2001 and during follow-up, participants reported if they had ever been diagnosed with an eating disorder (n = 5316). Incident IBS cases were identified from four questionnaire cycles (2013, 2014, 2016, 2019), with participants specifying the year of diagnosis if occurring before the questionnaire date. Multivariable logistic regressions adjusting for age, body mass index, and depressive symptoms estimated the associations of interest.
Maladaptive weight control/eating behaviours were associated with increased IBS risk [ORs (95% CIs) for laxatives to lose weight = 3.67 (2.52-5.35), vomiting to lose weight = 1.83 (1.29-2.60), fasting to lose weight = 2.62 (1.86-3.70), and bingeing = 2.25 (1.54-3.28)] as was history of eating disorder diagnosis [OR (95% CI) = 3.42 (2.38-4.90)]. The magnitude of IBS risk increased with the frequency of maladaptive behaviours.
There is evidence for the potential role of early maladaptive weight control/eating behaviours in the development of adult IBS among females.
肠易激综合征（IBS）在饮食障碍患者中较为常见。这些疾病之间的关系可能是双向的。然而，关于先前有饮食障碍的人患 IBS 的风险数据在很大程度上仅限于横断面研究。
使用“今日成长研究（GUTS）”前瞻性评估女性青少年/成年时期不良的体重控制/饮食行为与随后发生 IBS 的关联。
从 1996 年（年龄：9-14 岁）开始，在随访期间，参与者报告过去一年为减肥而出现的不良饮食/体重控制行为的频率：自我诱导呕吐（n=5740）、使用泻药（n=5438）和禁食（n=5522），此外还报告了暴食（n=4459）。从 2001 年开始，在随访期间，参与者报告了他们是否曾被诊断患有饮食障碍（n=5316）。通过四个问卷周期（2013 年、2014 年、2016 年和 2019 年）确定 IBS 的发病情况，如果在问卷日期之前发生，则由参与者指定诊断年份。调整年龄、体重指数和抑郁症状的多变量逻辑回归估计了相关的关联。
不良的体重控制/饮食行为与 IBS 风险增加相关[使用泻药减肥的比值比（95%置信区间）=3.67（2.52-5.35），呕吐减肥的比值比=1.83（1.29-2.60），禁食减肥的比值比=2.62（1.86-3.70），暴食的比值比=2.25（1.54-3.28）]，以及饮食障碍诊断史[比值比（95%置信区间）=3.42（2.38-4.90）]。IBS 风险的大小随着不良行为的频率而增加。
有证据表明，女性早期不良的体重控制/饮食行为可能在成人 IBS 的发展中起作用。
