Background & Aims

It is not clear whether a healthy lifestyle affects mortality of patients with inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC).

Methods

We collected data form the Nurses’ Health Study (1986–2014), Nurses’ Health Study II (1991–2015), and Health Professionals Follow-up Study (1986–2014), which assess lifestyles with serial questionnaires. We estimated joint and individual associations between 5 healthy lifestyle factors after IBD diagnosis (never smoking, body mass index 18.5–24.9 kg/m², vigorous physical activity in the highest 50% with non-zero value, alternate Mediterranean diet score ≥4, and light drinking [0.1–5.0 g/d]) and mortality using Cox proportional hazards models.

Results

We documented 83 deaths in 363 patients with CD during 4741 person-years and 80 deaths in 465 patients with UC during 6061 person-years. The median age of IBD diagnosis was 55 y. Compared to patients with IBD with no healthy lifestyle factors, patients with IBD with 3–5 healthy lifestyle factors had a significant reduction in all-cause mortality (hazard ratio [HR], 0.29; 95% CI, 0.16–0.52; P_trend < .0001). This reduction was significant in patients with CD (P_trend = .003) as well as in patients with UC (P_trend = .0003). Individual associations were more than 25 pack-years (HR, 1.92; 95% CI, 1.24–2.97; P_trend < .0001), physical activity (HR according to quintiles, 0.55–0.31; P_trend = .001), Mediterranean diet (HR, 0.69; 95% CI, 0.49–0.98), and alcohol consumption (HR_{0.1-5 g/d} 0.61; 95% CI, 0.39–0.95 vs HR_{>15 g/d} 1.84; 95% CI, 1.02–3.32). The findings did not change when we adjusted for family history of IBD, immunomodulator use, and IBD-related surgery.

Conclusions

In an analysis of data from 3 large cohort studies, we associated adherence to a healthy lifestyle with reduced mortality in patients with CD or UC.

中文翻译：

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健康的生活方式与炎症性肠病患者的死亡率降低有关。

背景与目标

目前尚不清楚健康的生活方式是否会影响炎症性肠病 (IBD) 患者的死亡率，包括克罗恩病 (CD) 和溃疡性结肠炎 (UC)。

方法

我们从护士健康研究（1986-2014 年）、护士健康研究 II（1991-2015 年）和卫生专业人员随访研究（1986-2014 年）中收集数据，这些研究通过系列问卷调查评估生活方式。我们评估了 IBD 诊断后 5 种健康生活方式因素之间的联合和个体关联（从不吸烟、体重指数 18.5–24.9 kg/m ²、最高 50% 的剧烈体育活动且非零值、替代地中海饮食评分≥4、和少量饮酒 [0.1–5.0 g/d]) 和使用 Cox 比例风险模型的死亡率。

结果

我们记录了 4741 人年期间 363 名 CD 患者中的 83 人死亡和 6061 人年期间 465 名 UC 患者中的 80 人死亡。IBD 诊断的中位年龄为 55 岁。与没有健康生活方式因素的 IBD 患者相比，具有 3-5 个健康生活方式因素的 IBD 患者的全因死亡率显着降低（风险比 [HR]，0.29；95% CI，0.16-0.52；P_趋势< .0001）。这种减少在 CD 患者（P_趋势 = .003）和 UC 患者（P_趋势 = .0003）中是显着的。个体相关性超过 25 包年（HR，1.92；95% CI，1.24-2.97；P_趋势<.0001）、身体活动（根据五分位数的 HR，0.55-0.31；P_趋势 = .001）、地中海饮食（HR，0.69；95% CI，0.49–0.98）和饮酒（HR _{0.1-5 g/d} 0.61；95% CI，0.39–0.95 对比 HR _{>15 g/d} 1.84；95% CI，1.02–3.32）。当我们调整了 IBD 家族史、免疫调节剂使用和 IBD 相关手术后，结果没有改变。

结论

在一项来自 3 项大型队列研究的数据分析中，我们将坚持健康的生活方式与 CD 或 UC 患者的死亡率降低联系起来。