Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory for Digestive Health, National Clinical Research Center for Digestive Diseases, Beijing, China.
Diabetes Obes Metab. 2024 Nov;26(11):5107-5115. doi: 10.1111/dom.15852. Epub 2024 Aug 20.
To examine the bidirectional association between type 2 diabetes (T2D) and irritable bowel syndrome (IBS) in a large prospective population cohort.
Participants free of IBS at baseline in the UK Biobank were included in the analysis of T2D and incident IBS (cohort 1), with 11 140 T2D patients and 413 979 non-T2D patients. Similarly, those free of T2D at baseline were included in the analysis of IBS and incident T2D (cohort 2), with 21 944 IBS patients and 413 979 non-IBS patients. Diagnoses of T2D and IBS were based on International Classification of Disease-10 codes. The Cox proportional hazards model was used to estimate adjusted hazard ratios (HRs).
In cohort 1, 8984 IBS cases were identified during a median 14.5-year follow-up. Compared with non-T2D, T2D patients had a 39.0% increased risk of incident IBS (HR = 1.39, 95% confidence interval [CI]: 1.23-1.56, P < .001), with a higher IBS risk in those with higher fasting blood glucose levels (HR = 1.43, 95% CI: 1.19-1.72, P < .001) or longer T2D duration (HR = 1.47, 95% CI: 1.23-1.74, P < .001). In cohort 2, 29 563 incident T2D cases were identified. IBS patients had an 18.0% higher risk of developing T2D versus non-IBS patients (HR = 1.18, 95% CI: 1.12-1.24, P < .001). A similar excess T2D risk was observed in IBS patients with a duration of either less than 10 years, or of 10 years or longer. Further sensitivity analysis and subgroup analysis indicated consistent findings.
T2D and IBS exhibit a bidirectional association, with an increased risk of co-morbidity. Awareness of this association may improve the prevention and management of both diseases.
在一个大型前瞻性人群队列中，研究 2 型糖尿病（T2D）与肠易激综合征（IBS）之间的双向关联。
在英国生物库中，基线时无 IBS 的参与者被纳入 T2D 和新发 IBS 的分析（队列 1），其中包括 11140 名 T2D 患者和 413979 名非 T2D 患者。同样，基线时无 T2D 的参与者被纳入 IBS 和新发 T2D 的分析（队列 2），其中包括 21944 名 IBS 患者和 413979 名非 IBS 患者。T2D 和 IBS 的诊断基于国际疾病分类第 10 版编码。使用 Cox 比例风险模型估计调整后的风险比（HR）。
在队列 1 中，中位随访 14.5 年期间共确定了 8984 例 IBS 病例。与非 T2D 患者相比，T2D 患者新发 IBS 的风险增加了 39.0%（HR=1.39，95%置信区间[CI]：1.23-1.56，P<0.001），空腹血糖水平较高（HR=1.43，95%CI：1.19-1.72，P<0.001）或 T2D 持续时间较长（HR=1.47，95%CI：1.23-1.74，P<0.001）的患者风险更高。在队列 2 中，共确定了 29563 例新发 T2D 病例。与非 IBS 患者相比，IBS 患者发生 T2D 的风险增加了 18.0%（HR=1.18，95%CI：1.12-1.24，P<0.001）。在病程小于 10 年或 10 年或更长的 IBS 患者中，也观察到类似的 T2D 风险增加。进一步的敏感性分析和亚组分析显示了一致的结果。
T2D 和 IBS 之间存在双向关联，且共病风险增加。了解这种关联可能会改善这两种疾病的预防和管理。
