Background

Recent studies have suggested that irritable bowel syndrome (IBS) could be a risk factor for osteoporosis although the evidence is still limited. The current study aimed to comprehensively examine the risk of osteoporosis among patients with IBS using systematic review and meta-analysis technique.

Methodology

Literature search was independently conducted by two investigators using MEDLINE, EMBASE, and Google Scholar database up to October 2019. Eligible study must evaluate whether patients with IBS have a higher risk of osteoporosis and/or osteoporotic fracture. It could be either cross-sectional study, case-control study, or cohort study. Point estimates and standard errors from each eligible study were combined together using the generic inverse variance method of DerSimonian and Laird.

Results

Of the 320 articles identified from the three databases, four cohort and one cross-sectional study with 526,633 participants met the eligibility criteria and were included into the meta-analysis. All five studies investigated the risk of osteoporosis among patients with IBS, and the pooled analysis found that patients with IBS had a significantly higher risk of osteoporosis than individuals without IBS with the pooled risk ratio of 1.95 (95% CI, 1.04–3.64; I² 100%). Sensitivity analysis including only cohort studies found a lower RR (pooled RR 1.55; 95% CI, 1.39–1.72) with a lower I² (59%). Three studies investigated the risk of osteoporotic fracture, and the pooled analysis found that patients with IBS also had a higher risk of osteoporotic fracture than individuals without IBS with the pooled risk ratio of 1.58 although statistical significance was not reached (95% CI, 0.95–2.62; I² 99%). Sensitivity analysis including only cohort studies found a lower RR (pooled RR 1.27; 95% CI, 1.20–1.39) with a dramatically lower I² (0%). Limitations included high heterogeneity and reliance on diagnostic codes.

Conclusion

A significantly increased risk of osteoporosis among IBS patients was observed in this study. Early intervention to prevent the development of osteoporosis, such as weight-bearing exercise, adequate intake of vitamin D and calcium, and early screening for osteoporosis, may be beneficial to these patients although further studies are still required to confirm the efficacy and cost-effectiveness of this approach.

中文翻译：

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肠易激综合征与骨质疏松症的关联：系统评价和荟萃分析

背景

最近的研究表明，肠易激综合症（IBS）可能是骨质疏松的危险因素，尽管证据仍然有限。本研究旨在使用系统评价和荟萃分析技术全面检查IBS患者的骨质疏松风险。

方法

截至2019年10月，两名研究者使用MEDLINE，EMBASE和Google Scholar数据库独立进行文献检索。合格的研究必须评估IBS患者是否有更高的骨质疏松症和/或骨质疏松性骨折风险。它可以是横断面研究，病例对照研究或队列研究。使用DerSimonian和Laird的通用逆方差方法将每个合格研究的点估计值和标准误差组合在一起。

结果

从这三个数据库中鉴定出的320篇文章中，有526,633名参与者进行了四项队列研究和一项横断面研究，符合入选标准，并被纳入荟萃分析。所有五项研究均调查了IBS患者中骨质疏松症的风险，汇总分析发现，IBS患者的骨质疏松症风险显着高于无IBS患者，合并风险比为1.95（95％CI，1.04-3.64；I ² 100％）。仅包括队列研究的敏感性分析发现RR较低（合并RR 1.55； 95％CI为1.39–1.72），I ²较低（59％）。三项研究调查了骨质疏松性骨折的风险，汇总分析发现与IBS患者相比，IBS患者的骨质疏松性骨折风险也更高，合并风险比为1.58，尽管未达到统计学显着性（95％CI，0.95– 2.62；我² 99％）。仅包括队列研究的敏感性分析发现RR较低（合并RR 1.27； 95％CI为1.20-1.39），而I ^2则大大降低（0％）。局限性包括高度异质性和对诊断代码的依赖。

结论

在这项研究中观察到IBS患者中骨质疏松症的风险显着增加。尽早干预以预防骨质疏松症的发展，例如负重运动，充足的维生素D和钙的摄入以及及早筛查骨质疏松症，对这些患者可能是有益的，尽管仍需要进一步的研究以确认其有效性和成本效益。这种方法。