Rodriguez Stephanie Hosanna, Hoilat Gilles Jadd, Pradhan Nikash, Gonzalez Bravo Carolina, Correia Marcelo L G, Mokadem Mohamad
Department of Internal Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
Division of Gastroenterology and Hepatology, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA.
Nutrients. 2025 Apr 29;17(9):1514. doi: 10.3390/nu17091514.
BACKGROUND/OBJECTIVES: Ileitis, or inflammation of the terminal ileum, is often linked to inflammatory bowel disease (IBD), especially Crohn's disease, but may also arise from non-steroidal anti-inflammatory drug (NSAID) use. While NSAIDs are known to cause gastrointestinal injury, their role in ileitis and downstream metabolic consequences remains unclear. This study evaluated the relationship between NSAID use, biopsy-confirmed ileitis, and glucose metabolism abnormalities in patients with and without IBD.
We conducted a retrospective cohort study of 3725 adults who underwent ileal biopsy between 2009 and 2022 at a tertiary care center. Patients were stratified based on histologic evidence of ileitis. Collected data included demographics, IBD status, NSAID and steroid use, hemoglobin A1C, fasting glucose, and diagnoses of abnormal glucose metabolism. Multivariable logistic and linear regression models adjusted for age, BMI, sex, steroid use, and IBD.
Of 3725 patients, 876 had biopsy-confirmed ileitis. NSAID use-categorized as current, historical, or inpatient-was not significantly associated with ileitis after adjustment. In contrast, IBD was the strongest independent predictor ( < 0.05). Although unadjusted analyses showed lower A1C in the ileitis group ( = 0.003), this was not significant after controlling for confounders ( = 0.084). No significant associations were found between ileitis and fasting glucose or abnormal glucose metabolism. Age and BMI were the dominant predictors of glycemic abnormalities.
NSAID use was not associated with biopsy-confirmed ileitis or impaired glucose metabolism. Traditional metabolic risk factors were stronger predictors of glycemic abnormalities than localized ileal inflammation.
背景/目的：回肠炎，即回肠末端的炎症，通常与炎症性肠病（IBD）相关，尤其是克罗恩病，但也可能由非甾体抗炎药（NSAID）的使用引起。虽然已知NSAIDs会导致胃肠道损伤，但其在回肠炎及下游代谢后果中的作用仍不清楚。本研究评估了使用NSAIDs、经活检确诊的回肠炎与有无IBD患者的葡萄糖代谢异常之间的关系。
我们对2009年至2022年在一家三级医疗中心接受回肠活检的3725名成年人进行了一项回顾性队列研究。根据回肠炎的组织学证据对患者进行分层。收集的数据包括人口统计学资料、IBD状态、NSAIDs和类固醇的使用情况、糖化血红蛋白、空腹血糖以及葡萄糖代谢异常的诊断。多变量逻辑回归和线性回归模型对年龄、体重指数、性别、类固醇使用情况和IBD进行了校正。
在3725名患者中，876人经活检确诊为回肠炎。调整后，NSAIDs的使用（分为当前使用、既往使用或住院期间使用）与回肠炎无显著关联。相比之下，IBD是最强的独立预测因素（<0.05）。尽管未校正的分析显示回肠炎组的糖化血红蛋白较低（=0.003），但在控制混杂因素后这一差异并不显著（=0.084）。回肠炎与空腹血糖或葡萄糖代谢异常之间未发现显著关联。年龄和体重指数是血糖异常的主要预测因素。
NSAIDs的使用与经活检确诊的回肠炎或葡萄糖代谢受损无关。传统的代谢危险因素比局部回肠炎症更能预测血糖异常。
