{"title":"Risk of stroke in patients with inflammatory bowel disease: a systematic review and meta-analysis.","authors":"Chao Luo, Lingpei Liu, Di Zhu, Zuanmin Ge, Yuehua Chen, Feng Chen","doi":"10.1186/s12876-025-03702-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Current studies suggest a potential link between inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), and cardiovascular diseases, such as stroke. This study aimed to assess the risk of stroke in IBD patients compared to general population.</p><p><strong>Methods: </strong>Systematic search was done in PubMed, Embase, CENTRAL, Scopus, and CINAHL databases for studies published till September 2023. Using a random-effects model, the hazard ratios (HRs) with 95% confidence intervals (CIs) for stroke occurrence were calculated. Subgroup analyses were done to estimate pooled HR with 95%CI for CD, UC, and overall IBD cases separately. Publication bias assessment was done by Begg's and Egger's tests.</p><p><strong>Results: </strong>Thirteen studies with 2,802,955 participants were included. IBD patients in general had significantly higher risk of stroke, with HR of 1.30 [95% CI 1.21-1.39]. Subgroup analysis demonstrated an HR of 1.35 [95% CI 1.22-1.49] for CD and 1.15 [95% CI 1.09-1.22] for UC. Substantial heterogeneity was detected across studies, with no substantial publication bias. Sensitivity analyses affirmed the stability of findings.</p><p><strong>Conclusion: </strong>IBD in general, and Crohn's disease in particular are associated with significantly higher risk of stroke. Our findings further emphasize the importance of cardiovascular risk assessment and management strategies in IBD care.</p><p><strong>Protocol registration: </strong>PROSPERO, CRD42023470602.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"114"},"PeriodicalIF":2.5000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853978/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12876-025-03702-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
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Abstract
Background: Current studies suggest a potential link between inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), and cardiovascular diseases, such as stroke. This study aimed to assess the risk of stroke in IBD patients compared to general population.
Methods: Systematic search was done in PubMed, Embase, CENTRAL, Scopus, and CINAHL databases for studies published till September 2023. Using a random-effects model, the hazard ratios (HRs) with 95% confidence intervals (CIs) for stroke occurrence were calculated. Subgroup analyses were done to estimate pooled HR with 95%CI for CD, UC, and overall IBD cases separately. Publication bias assessment was done by Begg's and Egger's tests.
Results: Thirteen studies with 2,802,955 participants were included. IBD patients in general had significantly higher risk of stroke, with HR of 1.30 [95% CI 1.21-1.39]. Subgroup analysis demonstrated an HR of 1.35 [95% CI 1.22-1.49] for CD and 1.15 [95% CI 1.09-1.22] for UC. Substantial heterogeneity was detected across studies, with no substantial publication bias. Sensitivity analyses affirmed the stability of findings.
Conclusion: IBD in general, and Crohn's disease in particular are associated with significantly higher risk of stroke. Our findings further emphasize the importance of cardiovascular risk assessment and management strategies in IBD care.
背景：目前的研究表明，炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC），与心血管疾病（如中风）之间存在潜在联系。本研究旨在评估IBD患者与普通人群相比发生卒中的风险。方法：系统检索PubMed、Embase、CENTRAL、Scopus和CINAHL数据库，检索截至2023年9月发表的研究。采用随机效应模型，计算卒中发生的风险比（hr）和95%置信区间（ci）。分别进行亚组分析，以95%CI估计CD、UC和总体IBD病例的总HR。发表偏倚评估采用Begg’s和Egger’s检验。结果：纳入13项研究，共2802955名受试者。总体而言，IBD患者卒中风险明显较高，HR为1.30 [95% CI 1.21-1.39]。亚组分析显示，CD的HR为1.35 [95% CI 1.22-1.49]， UC的HR为1.15 [95% CI 1.09-1.22]。在研究中发现了大量的异质性，没有明显的发表偏倚。敏感性分析证实了结果的稳定性。结论：一般来说，IBD，特别是克罗恩病与卒中风险显著升高相关。我们的研究结果进一步强调了心血管风险评估和管理策略在IBD护理中的重要性。协议注册：PROSPERO， CRD42023470602。
期刊介绍：
BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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