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Bidirectional Association between Asthma and Irritable Bowel Syndrome: Two Population-Based Retrospective Cohort Studies.

Shen TC, Lin CL, Wei CC, Chen CH, Tu CY, Hsia TC, Shih CM, Hsu WH, Sung FC, Kao CH - PLoS ONE (2016)

Bottom Line: The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.

View Article: PubMed Central - PubMed

Affiliation: Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan.

ABSTRACT

Background: There is a demonstrated association between asthma and irritable bowel syndrome (IBS). In this study, we examined the bidirectional association between asthma and IBS using a nationwide database.

Methods: We conducted two retrospective cohort studies using data obtained from the National Health Insurance of Taiwan. Study 1 included 29,648 asthma patients newly diagnosed between 2000 and 2010. Study 2 included 29,875 IBS patient newly diagnosed between 2000 and 2010. For each study, four subjects without asthma and IBS were selected, respectively, frequency-matched by sex, age, and the diagnosis date. All four cohorts were followed up until the end of 2011 to estimate incident IBS for Study 1 and incident asthma for study 2. Adjusted hazard ratios (aHRs) were estimated using the Cox proportional hazards model after controlling for sex, age and comorbidities.

Results: The incidence of IBS was 1.89 times higher in the asthma cohort than in the comparison cohort (8.26 vs. 4.36 per 1,000 person-years), with an aHR of 1.57 [95% confidence interval (CI) = 1.47-1.68]. The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities. In contrast, the incidence of asthma was 1.76 times higher in the IBS cohort than the comparison cohort (7.09 vs. 4.03 per 1,000 person-years), with an aHR of 1.54 (95% CI = 1.44-1.64). Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.

Conclusion: The present study suggests a bidirectional association between asthma and IBS. Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.

No MeSH data available.


Related in: MedlinePlus

Flow chart showing selection of study subjects.
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pone.0153911.g001: Flow chart showing selection of study subjects.

Mentions: Fig 1 shows the process of identifying relevant study subjects for the two retrospective cohort studies. For Study 1, we identified patients aged ≥ 20 years with asthma diagnosis between 2000 and 2010 (ICD-9-CM code 493) for the asthma cohort. Those with asthma diagnosis before 2000 were excluded. To ensure the accuracy of asthma diagnosis, we selected only subjects who had received medications for asthma, including inhaled/systemic bronchodilator or inhaled/systemic corticosteroid into the asthma cohort. We excluded subjects with a diagnosis of IBS (ICD-9-CM code 564.1) before 2000 and those with incomplete medical information. For Study 2, patients aged ≥ 20 years with IBS diagnosis between 2000 and 2010 were identified from the same claims data. Those with IBS diagnosis before 2000 were excluded. Patients who had been diagnosed with asthma before 2000 and those with missing medical information were also excluded.


Bidirectional Association between Asthma and Irritable Bowel Syndrome: Two Population-Based Retrospective Cohort Studies.

Shen TC, Lin CL, Wei CC, Chen CH, Tu CY, Hsia TC, Shih CM, Hsu WH, Sung FC, Kao CH - PLoS ONE (2016)

Flow chart showing selection of study subjects.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836663&req=5

pone.0153911.g001: Flow chart showing selection of study subjects.
Mentions: Fig 1 shows the process of identifying relevant study subjects for the two retrospective cohort studies. For Study 1, we identified patients aged ≥ 20 years with asthma diagnosis between 2000 and 2010 (ICD-9-CM code 493) for the asthma cohort. Those with asthma diagnosis before 2000 were excluded. To ensure the accuracy of asthma diagnosis, we selected only subjects who had received medications for asthma, including inhaled/systemic bronchodilator or inhaled/systemic corticosteroid into the asthma cohort. We excluded subjects with a diagnosis of IBS (ICD-9-CM code 564.1) before 2000 and those with incomplete medical information. For Study 2, patients aged ≥ 20 years with IBS diagnosis between 2000 and 2010 were identified from the same claims data. Those with IBS diagnosis before 2000 were excluded. Patients who had been diagnosed with asthma before 2000 and those with missing medical information were also excluded.

Bottom Line: The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.

View Article: PubMed Central - PubMed

Affiliation: Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan.

ABSTRACT

Background: There is a demonstrated association between asthma and irritable bowel syndrome (IBS). In this study, we examined the bidirectional association between asthma and IBS using a nationwide database.

Methods: We conducted two retrospective cohort studies using data obtained from the National Health Insurance of Taiwan. Study 1 included 29,648 asthma patients newly diagnosed between 2000 and 2010. Study 2 included 29,875 IBS patient newly diagnosed between 2000 and 2010. For each study, four subjects without asthma and IBS were selected, respectively, frequency-matched by sex, age, and the diagnosis date. All four cohorts were followed up until the end of 2011 to estimate incident IBS for Study 1 and incident asthma for study 2. Adjusted hazard ratios (aHRs) were estimated using the Cox proportional hazards model after controlling for sex, age and comorbidities.

Results: The incidence of IBS was 1.89 times higher in the asthma cohort than in the comparison cohort (8.26 vs. 4.36 per 1,000 person-years), with an aHR of 1.57 [95% confidence interval (CI) = 1.47-1.68]. The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities. In contrast, the incidence of asthma was 1.76 times higher in the IBS cohort than the comparison cohort (7.09 vs. 4.03 per 1,000 person-years), with an aHR of 1.54 (95% CI = 1.44-1.64). Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities.

Conclusion: The present study suggests a bidirectional association between asthma and IBS. Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.

No MeSH data available.


Related in: MedlinePlus