IBD:接受治疗的炎症性肠病患者乳糜泻发病率较低

2022-03-06 MedSci原创 MedSci原创

乳糜泻一般指麦胶性肠病。 麦胶性肠病又称乳糜泻、非热带性脂肪泻,在北美、北欧、澳大利亚发病率较高,国内很少见。男女之比为1∶1.3~2.0,女性多于男性,发病高峰年龄主要是儿童与青年。

      乳糜泻被认为是最常见的免疫介导的疾病之一,在美国的总体发病率在0.7%至1%之间。乳糜泻和炎症性肠病(IBD)相似的特点是慢性免疫介导的胃肠道炎症。两者的发病原因都较为复杂,可能是遗传和环境因素导致了免疫反应的失调。与普通人群相比,IBD患者中HLA-乳糜泻基因型的患病率并不高。此外,环境因素在乳糜泻中得到了更多的公认,其中麸质饮食的摄入是主要的推测因素。有几项研究报告了乳糜泻和IBD之间的关系,但缺乏证据,因此,本项研究试图评估乳糜泻和IBD之间的关系,并探究不同IBD药物对乳糜泻的影响。

 

      研究人员通过查询一个包含了美国26个医疗保健系统多中心数据库(Explorys Inc.)进行了相关数据的采集,对 1999 年至 2020 年期间确定的患有乳糜泻和 IBD 的患者进行了筛选和纳入,最后使用多变量模型进行了统计分析寻找差异。

 

       在数据库中的 72,965,940 人中,133,400 人患有乳糜泻(0.18%),191,570 人(0.26%)患有溃疡性结肠炎(UC),230,670 人(0.32%)患有克罗恩病(CD)。IBD 患者更有可能被诊断为乳糜泻( [OR],13.680),其中乳糜泻与 CD 的相关性更大。与未接受 IBD 治疗的患者相比,接受治疗的 UC 和 CD 患者与乳糜泻相关的风险较低,特别是皮质类固醇(OR,0.407 和 0.585)、5-氨基水杨酸盐​​(OR,0.124 和 0.127)、免疫调节剂(OR , 0.385 和 0.425) 和抗肿瘤坏死因子药物 (OR, 0.215 和 0.242)的使用可以明显降低乳糜泻的发生率和严重程度。维多珠单抗组没有较低的风险关联,但优特克单抗组有较高的风险关联。

 

      在本项研究中,研究人员展示了乳糜泻和 IBD 之间的双向关联,而且乳糜泻的发生与 CD 的关系更强。使用皮质类固醇、5-氨基水杨酸盐、免疫调节剂或抗肿瘤坏死因子药物治疗的 IBD 患者与乳糜泻的相关性较低。需要更多的研究来确定 IBD 治疗相关改变乳糜泻发病率的潜在机制。

原始出处:

Motasem Alkhayyat. Et al. Patients With Inflammatory Bowel Disease on Treatment Have Lower Rates of Celiac Disease Get access Arrow.Inflammatory Bowel Diseases.2022.

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    2022-03-08 bnurmamat
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炎性肠病又称炎症性肠病(IBD),为累及回肠、直肠、结肠的一种特发性肠道炎症性疾病。临床表现腹泻、腹痛,甚至可有血便。本病包括溃疡性结肠炎(UC)和克罗恩病(CD)。

IBD: 中国炎症性肠病患者出现心血管事件风险明显增高

根据最新研究,炎症性肠病(IBD)患者的缺血性心脏病、心血管疾病和外周动脉疾病事件的风险增加,这在55岁以下的人群中风险最高。

Clin Gastroenterology H:炎症性肠病发病风险与疾病表型之间的相关性

炎症性肠病是一种持续或反复发作的疾病,是起始于胃肠道黏膜的炎症。炎症可出现在消化道的任何部分,从口腔到肛门,例如直肠或小肠。