兰州大学循证社会科学交叉创新实验室 Innovation Laboratory of Evidence-based Social Sciences,Lanzhou University

Cholecystectomy is associated with a higher risk of irritable bowel syndrome in the UK Biobank: a prospective cohort study

Wenbo Meng; Peng Nie; Linzhi Lu
2023-12-08
Background: Recent studies have shown that bile acids are essential in irritable bowel syndrome (IBS) pathology, and cholecystectomy has direct effects on bile acid metabolism. However, whether cholecystectomy increases the risk of IBS remains unclear. We aimed to investigate the association between cholecystectomy and IBS risk in the UK Biobank (UKB). Methods: This study is a prospective analysis of 413,472 participants who were free of IBS, inflammatory bowel disease, cancer, or common benign digestive tract diseases. We identified incidents of IBS through self-reporting or links to primary healthcare and hospitalization data. We evaluated hazard ratios (HRs) adjusted for sociodemographic characteristics, health behaviours, comorbidities, and medications. Results: During a median follow-up period of 12.7 years, we observed 15,503 new cases of IBS. Participants with a history of cholecystectomy had a 46% higher risk of IBS than those without (HR = 1.46, 95% CI: 1.32–1.60), and further subtype analysis showed that the risk of IBS with diarrhoea was significantly higher than the risk of IBS without diarrhoea (HR = 1.71, 95% CI: 1.30–2.25 vs. HR = 1.42, 95% CI: 1.28–1.58). The overall covariate-adjusted HRs for IBS were similar between the group with both cholecystectomy and gallstones (HR = 1.45, 95% CI: 1.32–1.58) and the group with cholecystectomy without gallstones (HR = 1.50, 95% CI: 1.36–1.67) when the group without both cholecystectomy and gallstones was used as a reference. The overall covariate-adjusted HR was not significantly different in the group without cholecystectomy with gallstones (HR = 1.18, 95% CI: 0.95–1.47). The positive association of cholecystectomy with IBS risk did not change when stratifying the data based on age, sex, BMI, smoking, alcohol consumption, healthy diet, quality sleep, physical activity, type 2 diabetes, hypertension, hyperlipidaemia, mental illness, NSAID intake, or acid inhibitor intake. Sensitivity analyses, including propensity score matching analysis and lagging the exposure for two or four years, indicated that the effects were robust. Conclusion: Cholecystectomy was associated with a higher risk of IBS, especially IBS with diarrhoea. Additional prospective randomized controlled and experimental studies are warranted to further validate the association and to explore the relevant biological mechanisms.
FRONTIERS IN PHARMACOLOGY
卷号:14|期号:NR|页码:NR
ISSN:NR|收录类别:SCIE
DOI
DOI: 10.3389/fphar.2023.1244563
EISSN
1663-9812
出版日期
2023-12-08
资助信息
National Natural Science Foundation of China (NSFC) (82103913; 82204123); Medical Innovation and Development Project of Lanzhou University (lzuyxcx-2022-157)
相关链接
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1244563/full
语种
英语
国家
中国
学科领域
循证医学
WOS学科分类
Pharmacology & Pharmacy
被引频次(WOS)
1
来源机构
兰州大学循证社会科学研究中心
研究类型
其他
关键词
cholecystectomy irritable bowel syndrome cohort study prospective analysis UK Biobank
资助机构
教育部 国家自然科学基金委