{"title":"炎症性肠病的肝胆胰表现：荟萃分析综述","authors":"Runsheng Hong, Zhixue Li, Meng Li, Yun Dai","doi":"10.1177/17562848241311165","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), can affect the hepatobiliary system and pancreas, substantially impacting the life quality of patients.</p><p><strong>Objectives: </strong>To evaluate the quality of evidence and comprehensively assess the validity of associations of IBD with hepatobiliary and pancreatic diseases.</p><p><strong>Design: </strong>We performed an umbrella review of existing meta-analyses in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) recommendations.</p><p><strong>Data sources and methods: </strong>We systematically searched PubMed, Embase, and Web of Science from inception to April 2024, to identify and appraise meta-analyses examining IBD and risk of hepatobiliary and pancreatic manifestations. Methodologic quality was assessed with A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) and the strength of evidence was graded according to prespecified criteria.</p><p><strong>Results: </strong>A total of 14 meta-analyses of observational studies were included. The strongest-validity evidence suggested the significant associations between IBD and risk of gallstones (odds ratio (OR) = 1.72; 95% confidence interval (CI) = 1.40-2.12) and acute pancreatitis (OR = 3.11; 95% CI = 2.93-3.30). Highly suggestive evidence indicated a significantly increased risk of hepatobiliary cancer in UC (incidence rate ratio (IRR) = 2.05; 95% CI = 1.52-2.76) and CD (IRR = 2.31; 95% CI = 1.25-4.28). In addition, highly suggestive evidence indicated that IBD was associated with portal venous system thrombosis. Suggestive evidence showed a significantly higher prevalence of primary sclerosing cholangitis, non-alcoholic fatty liver disease, autoimmune hepatitis, and autoimmune pancreatitis in IBD patients than in the general population.</p><p><strong>Conclusion: </strong>The associations between IBD and multiple hepatobiliary and pancreatic disorders showed varying levels of evidence and magnitude of risk. Further high-quality primary studies are needed to identify IBD patients who are more at risk and would benefit the most from screening and prevention programs.</p><p><strong>Trial registration prospero: </strong>CRD42023451461.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848241311165"},"PeriodicalIF":3.9000,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705336/pdf/","citationCount":"0","resultStr":"{\"title\":\"Hepatobiliary and pancreatic manifestations in inflammatory bowel disease: an umbrella review of meta-analyses.\",\"authors\":\"Runsheng Hong, Zhixue Li, Meng Li, Yun Dai\",\"doi\":\"10.1177/17562848241311165\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), can affect the hepatobiliary system and pancreas, substantially impacting the life quality of patients.</p><p><strong>Objectives: </strong>To evaluate the quality of evidence and comprehensively assess the validity of associations of IBD with hepatobiliary and pancreatic diseases.</p><p><strong>Design: </strong>We performed an umbrella review of existing meta-analyses in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) recommendations.</p><p><strong>Data sources and methods: </strong>We systematically searched PubMed, Embase, and Web of Science from inception to April 2024, to identify and appraise meta-analyses examining IBD and risk of hepatobiliary and pancreatic manifestations. Methodologic quality was assessed with A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) and the strength of evidence was graded according to prespecified criteria.</p><p><strong>Results: </strong>A total of 14 meta-analyses of observational studies were included. The strongest-validity evidence suggested the significant associations between IBD and risk of gallstones (odds ratio (OR) = 1.72; 95% confidence interval (CI) = 1.40-2.12) and acute pancreatitis (OR = 3.11; 95% CI = 2.93-3.30). Highly suggestive evidence indicated a significantly increased risk of hepatobiliary cancer in UC (incidence rate ratio (IRR) = 2.05; 95% CI = 1.52-2.76) and CD (IRR = 2.31; 95% CI = 1.25-4.28). In addition, highly suggestive evidence indicated that IBD was associated with portal venous system thrombosis. Suggestive evidence showed a significantly higher prevalence of primary sclerosing cholangitis, non-alcoholic fatty liver disease, autoimmune hepatitis, and autoimmune pancreatitis in IBD patients than in the general population.</p><p><strong>Conclusion: </strong>The associations between IBD and multiple hepatobiliary and pancreatic disorders showed varying levels of evidence and magnitude of risk. 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引用次数: 0
摘要
背景：炎症性肠病（IBD），包括溃疡性结肠炎（UC）和克罗恩病（CD），可影响肝胆系统和胰腺，严重影响患者的生活质量。目的：评价证据质量，综合评价IBD与肝胆胰疾病相关性的有效性。设计：我们按照系统评价和荟萃分析首选报告项目（PRISMA）的建议，对现有的荟萃分析进行了综合评价。数据来源和方法：我们系统地检索了PubMed， Embase和Web of Science从成立到2024年4月，以确定和评估检查IBD和肝胆胰表现风险的荟萃分析。采用评估系统评价的测量工具（AMSTAR 2）对方法学质量进行评估，并根据预先规定的标准对证据的强度进行分级。结果：共纳入14项观察性研究的meta分析。最强效度证据表明IBD与胆结石风险之间存在显著关联(优势比(OR) = 1.72；95%可信区间(CI) = 1.40-2.12)和急性胰腺炎(OR = 3.11；95% ci = 2.93-3.30)。高度提示性证据表明UC患者肝胆癌风险显著增加(发病率比(IRR) = 2.05；95% CI = 1.52-2.76)和CD (IRR = 2.31；95% ci = 1.25-4.28)。此外，极具启发性的证据表明IBD与门静脉系统血栓形成有关。暗示性证据显示，IBD患者的原发性硬化性胆管炎、非酒精性脂肪性肝病、自身免疫性肝炎和自身免疫性胰腺炎的患病率明显高于普通人群。结论：IBD与多种肝胆胰疾病之间的关联显示出不同程度的证据和风险程度。需要进一步的高质量的初步研究来确定IBD患者的风险更高，并从筛查和预防计划中获益最多。试验注册号：CRD42023451461。
Hepatobiliary and pancreatic manifestations in inflammatory bowel disease: an umbrella review of meta-analyses.
Background: Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), can affect the hepatobiliary system and pancreas, substantially impacting the life quality of patients.
Objectives: To evaluate the quality of evidence and comprehensively assess the validity of associations of IBD with hepatobiliary and pancreatic diseases.
Design: We performed an umbrella review of existing meta-analyses in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) recommendations.
Data sources and methods: We systematically searched PubMed, Embase, and Web of Science from inception to April 2024, to identify and appraise meta-analyses examining IBD and risk of hepatobiliary and pancreatic manifestations. Methodologic quality was assessed with A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) and the strength of evidence was graded according to prespecified criteria.
Results: A total of 14 meta-analyses of observational studies were included. The strongest-validity evidence suggested the significant associations between IBD and risk of gallstones (odds ratio (OR) = 1.72; 95% confidence interval (CI) = 1.40-2.12) and acute pancreatitis (OR = 3.11; 95% CI = 2.93-3.30). Highly suggestive evidence indicated a significantly increased risk of hepatobiliary cancer in UC (incidence rate ratio (IRR) = 2.05; 95% CI = 1.52-2.76) and CD (IRR = 2.31; 95% CI = 1.25-4.28). In addition, highly suggestive evidence indicated that IBD was associated with portal venous system thrombosis. Suggestive evidence showed a significantly higher prevalence of primary sclerosing cholangitis, non-alcoholic fatty liver disease, autoimmune hepatitis, and autoimmune pancreatitis in IBD patients than in the general population.
Conclusion: The associations between IBD and multiple hepatobiliary and pancreatic disorders showed varying levels of evidence and magnitude of risk. Further high-quality primary studies are needed to identify IBD patients who are more at risk and would benefit the most from screening and prevention programs.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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