Alghamdi Ahmed G, Alanazi Aisha M, Nourelden Anas Z, Alhamidi Hussam A, Al Ibrahim Bashaar K, Alshowair Mishal A, Tawfik Marwa M, Bawazir Abdullah H, Nagadi Omar S, Alshehri Hameed M, Alahmari Mohammed S
Department of Gastroenterology and Hepatology, King Fahad Medical City, Riyadh, Saudi Arabia.
Department of Internal Medicine, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.
Saudi J Gastroenterol. 2025 Jan 1;31(1):41-49. doi: 10.4103/sjg.sjg_259_24. Epub 2024 Dec 30.
Approximately 25% of individuals with inflammatory bowel disease (IBD) concurrently experience immune-mediated inflammatory diseases (IMIDs), while the overall prevalence of these conditions in the general population is 5-7%. Individuals with IBD and concurrent IMIDs tend to have a more aggressive disease profile. We aimed to assess the prevalence of coexisting autoimmune disorders among patients with IBD and their association with inflammatory bowel disease type.
In this cross-sectional study at a tertiary care center in Riyadh, Saudi Arabia, we examined 875 patients with IBD (530 with Crohn's disease and 345 with ulcerative colitis). Patient demographics, disease types, treatment modalities, and co-occurring autoimmune conditions were analyzed using statistical and regression analyses.
Overall, 21.7%, 19.4%, and 25.2% of the patients had IMIDs, Crohn's disease, and ulcerative colitis, respectively. Patients with ulcerative colitis had higher rates of hepatic autoimmune conditions (9.6%) and endocrine autoimmune diseases (4.1% vs 1.3%; P = 0.010) than those with Crohn's disease (4.5%; P = 0.003). Regression analysis revealed significant associations between hepatic (P = 0.012) and endocrine autoimmune diseases (P = 0.018) with ulcerative colitis diagnosis, although the model's predictive accuracy was moderate (overall, 63%; specificity, 95%; sensitivity, 14%).
Our study highlights the significant co-occurrence of autoimmune diseases with IBD, particularly the distinct autoimmune profiles of Crohn's disease and ulcerative colitis. Identifying the specific ulcerative colitis-associated autoimmune comorbidities could guide personalized therapeutic strategies and inform future research on the pathophysiological relationship between these conditions.
约25%的炎症性肠病（IBD）患者同时患有免疫介导的炎症性疾病（IMID），而这些疾病在普通人群中的总体患病率为5 - 7%。患有IBD并同时患有IMID的个体往往具有更严重的疾病特征。我们旨在评估IBD患者中共存自身免疫性疾病的患病率及其与炎症性肠病类型的关联。
在沙特阿拉伯利雅得的一家三级医疗中心进行的这项横断面研究中，我们检查了875例IBD患者（530例克罗恩病患者和345例溃疡性结肠炎患者）。使用统计和回归分析对患者的人口统计学、疾病类型、治疗方式和同时出现的自身免疫性疾病情况进行了分析。
总体而言，分别有21.7%、19.4%和25.2%的患者患有IMID、克罗恩病和溃疡性结肠炎。与克罗恩病患者（4.5%；P = 0.003）相比，溃疡性结肠炎患者的肝脏自身免疫性疾病发生率更高（9.6%），内分泌自身免疫性疾病发生率更高（4.1%对1.3%；P = 0.010）。回归分析显示，肝脏自身免疫性疾病（P = 0.012）和内分泌自身免疫性疾病（P = 0.018）与溃疡性结肠炎诊断之间存在显著关联，尽管该模型的预测准确性中等（总体为63%；特异性为95%；敏感性为14%）。
我们的研究强调了自身免疫性疾病与IBD的显著共存，特别是克罗恩病和溃疡性结肠炎不同的自身免疫特征。识别与溃疡性结肠炎相关的特定自身免疫性合并症可以指导个性化治疗策略，并为未来关于这些疾病之间病理生理关系的研究提供信息。
