袁金秋+孟文勃+张常华:65万人数据揭示,常用质子泵抑制剂或增加IBD风险
创作:aluba 审核:aluba 2021年08月17日
  • 纳入3个队列(NHS 82869人、NHS II 95141人、UK Biobank 469397人),在NHS队列(中位随访12年)及UK Biobank队列(中位随访8.1年)中,各发生271例及1419例IBD;
  • 在NHS队列及UK Biobank队列中,定期使用质子泵抑制剂均与IBD风险呈显著正相关;
  • 综合3个队列的数据,与不使用质子泵抑制剂的受试者相比,定期使用质子泵抑制剂与IBD风险增加42%相关;
  • 与H2受体拮抗剂相比,质子泵抑制剂与IBD风险增加38%相关。
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aluba
中山大学附属第七医院的袁金秋团队、张常华团队与兰州大学第一医院的孟文勃团队在Gastroenterology上发表的一项前瞻性队列结果,对3个队列(共包含近65万人)进行多年随访后发现,相比于不使用质子泵抑制剂,或使用H2受体拮抗剂,定期使用质子泵抑制剂与IBD风险增加相关。
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Gastroenterology [IF:22.682]

Regular use of proton pump inhibitor and the risk of inflammatory bowel disease: pooled analysis of three prospective cohorts

定期使用质子泵抑制剂与IBD风险:对3项前瞻性队列研究的汇总分析

10.1053/j.gastro.2021.08.005

2021-08-10, Article

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BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have a major impact on gut microbiome and immune function which in turn, may increase the risk of inflammatory bowel disease (IBD). We undertake this study to evaluate PPI use and subsequent risk of IBD and subtypes (Crohn's disease [CD] and ulcerative colitis [UC]).
METHODS: This is a pooled analysis of Nurses’ Health Study (NHS, n=82 869), NHS II (n=95 141) and UK Biobank (n=469 397). We included participants with information on personal use of PPIs and free of IBD or cancer at baseline. We evaluated hazard ratios (HRs) and 95% confidence intervals (CIs) with COX regression adjusting for lifestyle factors, PPI indications, comorbidities, and other medications.
RESULTS: We documented 271 cases of IBD (median follow-up:12 years) in the pooled NHS cohorts and 1419 cases (median follow-up:8.1 years) in the UK Biobank. For both pooled NHS cohorts and UK Biobank, regular use of PPIs consistently showed a significantly positive association with IBD, CD and UC risk. Combined analyses of three cohorts showed that regular PPI users had an increased risk of IBD as compared with non-users (HR 1.42, 95%CI 1.22 to 1.65; number needed to harm 3 770, 95% CI 3 668 to 4 369). Direct comparison with H2 receptor antagonist, a less potent acid suppressor, showed that PPI use was also associated with higher IBD risk (HR 1.38, 95%CI 1.16 to 1.65).
CONCLUSIONS: Regular use of PPIs was associated with an increased risk of IBD and its subtypes. The findings should be interpreted with caution because the absolute risk was low and the clinical benefits of PPIs are substantial.

First Authors:
Bin Xia

Correspondence Authors:
Changhua Zhang,Wenbo Meng,Jinqiu Yuan

All Authors:
Bin Xia,Man Yang,Long H Nguyen,Qiangsheng He,Jie Zhen,Yuanyuan Yu,Mengyang Di,Xiwen Qin,Kuiqing Lu,Zi Chong Kuo,Yulong He,Changhua Zhang,Wenbo Meng,Jinqiu Yuan

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