Ruška Paola, Jerković Antonella, Sila Sara, Močić Pavić Ana, Krbot Skorić Magdalena, Habek Mario, Hojsak Iva
Department of Pediatrics, Children's Hospital Zagreb, Zagreb, Croatia.
Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
Clin Auton Res. 2025 May 19. doi: 10.1007/s10286-025-01134-8.
This study aimed to investigate the subjective and objective autonomic nervous system (ANS) abnormalities in children with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) compared with healthy children (HC).
In total, 69 children were enrolled: 23 in the IBD, 28 in the IBS, and 18 HC group. ANS symptoms were evaluated using the Composite Autonomic Symptom Score (COMPASS-31). The severity and distribution of ANS function were quantitated using adrenergic, cardiovagal, and sudomotor indices of the Composite Autonomic Severity Scale (CASS). Health-related quality of life (HRQoL) was assessed with the Pediatric Quality of Life Inventory (PedsQL).
Children with IBS scored highest on the COMPASS-31, followed by patients with IBD and HC (median 11.5, 6.3, and 1.7, respectively; p = 0.001). There was no significant difference between groups in CASS (p = 0.09); however, children with IBD had a higher score on the sudomotor index (p = 0.012). There was a significant difference in symptomatic autonomic dysfunction (defined as COMPASS-31 > 7.913 and CASS > 0) between children with IBS (61.5%) compared with children with IBD (42.1%) and HC (7.1%), p = 0.004. In multivariable logistic regression, the number of squats decreased the probability of special health care needs by 17.2%, and the presence of symptomatic autonomic dysfunction increased the probability by 515.4%.
The ANS is frequently affected in children with IBD and IBS; children with IBS show greater autonomic symptom burden, while children with IBD have greater sudomotor dysfunction. HRQoL is significantly influenced by observed ANS changes in both groups.
本研究旨在调查与健康儿童（HC）相比，炎症性肠病（IBD）和肠易激综合征（IBS）患儿的主观和客观自主神经系统（ANS）异常情况。
共纳入69名儿童：IBD组23名，IBS组28名，HC组18名。使用综合自主症状评分（COMPASS-31）评估自主神经症状。使用综合自主严重程度量表（CASS）的肾上腺素能、心血管迷走神经和汗腺运动指数对自主神经功能的严重程度和分布进行量化。使用儿童生活质量量表（PedsQL）评估健康相关生活质量（HRQoL）。
IBS患儿在COMPASS-31上得分最高，其次是IBD患儿和HC组（中位数分别为11.5、6.3和1.7；p = 0.001）。CASS在各组之间无显著差异（p = 0.09）；然而，IBD患儿的汗腺运动指数得分较高（p = 0.012）。IBS患儿（61.5%）与IBD患儿（42.1%）和HC组（7.1%）相比，有症状的自主神经功能障碍（定义为COMPASS-31 > 7.913且CASS > 0）存在显著差异，p = 0.004。在多变量逻辑回归中，蹲起次数使特殊医疗需求的概率降低了17.2%，有症状的自主神经功能障碍使概率增加了515.4%。
IBD和IBS患儿的自主神经系统经常受到影响；IBS患儿表现出更大的自主神经症状负担，而IBD患儿有更大的汗腺运动功能障碍。两组中观察到的自主神经变化均对HRQoL有显著影响。
