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Published on: November 30, 2016
Risk of autonomic dysfunction in irritable bowel syndrome: A nationwide matched cohort study
Youngoh Bae1, Won-Suk Shin2, Jin Hoon Park3
1Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea; Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Objective:
To examine whether irritable bowel syndrome (IBS) is associated with a higher long-term risk of clinically diagnosed autonomic dysfunction.
Methods:
A retrospective propensity score-matched cohort study was conducted using the Korean National Health Insurance Service-National Sample Cohort (2012-2023). IBS was defined using the ICD-10 code K58, and the index date was set as the first qualifying diagnosis. Autonomic dysfunction was defined as the first occurrence of outcome-defining ICD-10 G90 codes after the index date. Each IBS case was matched 1:2 to controls using demographic, lifestyle, metabolic, and socioeconomic covariates from the closest health screening. We estimated incidence rates, incidence rate ratios (IRRs), and hazard ratios (HRs) using Cox proportional hazards models. Sensitivity analyses considered IBS subtypes and alternative outcome code sets, including a definition excluding G90.2.
Results:
The final cohort included 142,391 individuals with IBS and 284,782 matched controls. Mean follow-up was 4.28 and 4.29 years, respectively. The incidence rate of autonomic dysfunction was 2.20 per 1000 person-years in the IBS group and 1.09 in controls (IRR 2.02). In fully adjusted models, IBS was associated with increased risk (HR 2.16, 95% CI 1.90-2.46). Findings were similar across subgroup and sensitivity analyses.
Conclusions:
IBS was associated with a substantially higher long-term risk of clinically diagnosed autonomic dysfunction in this nationwide matched cohort.
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