炎症性肠病与帕金森病发病风险的关联性研究——Meta分析与系统评价

Meta-analysis and Systematic Review of Relationship between Inflammatory Bowel Disease and Risk of Parkinson’s Disease

目的探究炎症性肠病(Inflammatory bowel diseases,IBD)与帕金森病(Parkinson disease,PD)发病风险的关联。方法计算机检索PubMed、Embase、The Cochrane Library、VIP、Wan Fang Data和CNKI数据库,搜集比较IBD患者与健康对照PD发病风险的研究,检索时限均从建库至2018年12月2日。由2名研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Stata MP 14. 0软件进行Meta分析。结果最终纳入5个研究,总人数9174766例,Meta分析结果显示,IBD、克罗恩病(Crohn disease,CD)和溃疡性结肠炎(Ulcerative colitis,UC)与PD发病没有关联[RR=1. 10,95%CI(0. 88,1. 36),P=0. 397]、[RR=1. 08,95%CI(0. 80,1. 45),P=0. 624]、[RR=0. 98,95%CI(0. 74,1. 29),P=0. 893]。进一步进行亚组分析及敏感性分析,高质量的队列研究提示,IBD增加PD发病风险[RR=1. 19,95%CI(1. 05,1. 36),P=0. 008]。结论当前证据显示,IBD、CD和UC与PD发病没有关联,但高质量研究倾向于IBD增加PD发病风险的结论。受纳入研究的数量和质量限制,上述结论尚待更多高质量、大样本的研究予以验证。

Objective To explore relationship between Inflammatory bowel diseases(IBD)and risk of Parkinson disease(PD).Methods PubMed,Embase,The Cochrane Library,VIP,Wan Fang Data and CNKI databases were searched to collect and compare studies regarding risk of developing PD between IBD patients and healthy controls,search time ranging from establishment of the database to December 2,2018.Meta-analysis was performed by using Stata MP 14.0 software after two investigators independently screened literatures,extracted the data,and assessed risk of bias in included studies.Results A Total of 5 studies were included,up to 9174766 cases.Meta-analysis showed that IBD,Crohn disease(CD)and Ulcerative colitis(UC)were not associated with PD RR=1.10,95%CI(0.88,1.36),P=0.397]、[RR=1.08,95%CI(0.80,1.45),P=0.624]、(RR=0.98,95%CI(0.74,1.29),P=0.893)Further subgroup analysis and sensitivity analysis were performed and high-quality cohort studies demonstrated that IBD increased risk of PD[RR=1.19,95%CI(1.05,1.36),P=0.008].Conclusion Current evidence reveals that IBD,CD,and UC are not associated with PD,but high-quality studies tend to show that IBD increases risk of PD.Subject to the quantitative and qualitative limitations of included studies,above conclusions deserve verification by more high quality and large sample studies.