Casandra Dolovich, Leigh Anne Shafer, Lesley A Graff, Kathy Vagianos, Kelcie Witges, Laura E Targownik, Charles N Bernstein
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Logistic regression analysis was used to assess the association between HC and IBD-related symptoms (IBDSI>14 for Crohn disease, >13 for ulcerative colitis), or inflammation (FCAL>250 ug/g) at any measurement point in the study.</p><p><strong>Results: </strong>Of 71 women, 17 (24%) reported taking HC in the 1 year period. Adjusting for age, disease type, disease duration, and smoking status, the odds of having increased IBD-related symptoms (IBDSI) during the year were lower for women using HC compared with women not using HC [adjusted odds ratio 0.16, 95% CI, 0.02-0.90]. Conversely, women using HC were more likely to have inflammation during the year [adjusted odds ratio 5.7, 95% CI, 1.23-43.6].</p><p><strong>Conclusions: </strong>HC use among women with IBD was associated with a lower likelihood of IBD-related symptoms but a higher likelihood of experiencing intestinal inflammation (FCAL>250 ug/g) over 1 year. Further work is needed to examine this dichotomous result, potentially examining aspects such as duration of HC use, and the types of HC.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hormonal Contraceptives Reduce Active Symptomatic Disease but May Increase Intestinal Inflammation in IBD.\",\"authors\":\"Casandra Dolovich, Leigh Anne Shafer, Lesley A Graff, Kathy Vagianos, Kelcie Witges, Laura E Targownik, Charles N Bernstein\",\"doi\":\"10.1097/MCG.0000000000001846\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Among women of reproductive age with inflammatory bowel disease (IBD), we aimed to assess the relationship of hormonal contraceptives (HCs) with IBD-related symptoms, and intestinal inflammation.</p><p><strong>Methods: </strong>A nested cohort of women in the longitudinal Manitoba Living with IBD Study, ages 18 to 49, were followed for 1 year, with bi-weekly online surveys. This included a validated measure of disease activity; IBD Symptom Inventory (IBDSI), and stool samples obtained at 3 time-points for assessment of fecal calprotectin (FCAL). Use of HC included oral and vaginal intrauterine devices. Logistic regression analysis was used to assess the association between HC and IBD-related symptoms (IBDSI>14 for Crohn disease, >13 for ulcerative colitis), or inflammation (FCAL>250 ug/g) at any measurement point in the study.</p><p><strong>Results: </strong>Of 71 women, 17 (24%) reported taking HC in the 1 year period. Adjusting for age, disease type, disease duration, and smoking status, the odds of having increased IBD-related symptoms (IBDSI) during the year were lower for women using HC compared with women not using HC [adjusted odds ratio 0.16, 95% CI, 0.02-0.90]. 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引用次数: 0
摘要
背景:在患有炎症性肠病(IBD)的育龄妇女中,我们旨在评估激素避孕药(HCs)与 IBD 相关症状和肠道炎症的关系:方法:我们对马尼托巴省IBD患者纵向研究(Manitoba Living with IBD Study)中的18至49岁女性进行了为期一年的嵌套队列跟踪,每两周进行一次在线调查。调查内容包括对疾病活动的有效测量;IBD症状量表(IBDSI),以及在3个时间点采集的粪便样本,用于评估粪便钙蛋白(FCAL)。HC 的使用包括口服和阴道宫内避孕器。逻辑回归分析用于评估 HC 与 IBD 相关症状(克罗恩病的 IBDSI>14,溃疡性结肠炎的 IBDSI>13)或研究中任何测量点的炎症(FCAL>250 ug/g)之间的关联:在 71 名女性中,有 17 人(24%)报告在 1 年内服用过 HC。在对年龄、疾病类型、病程和吸烟状况进行调整后,与未服用 HC 的女性相比,服用 HC 的女性在一年内出现 IBD 相关症状(IBDSI)加重的几率较低[调整后的几率比 0.16,95% CI,0.02-0.90]。相反,使用 HC 的女性在一年中更有可能出现炎症[调整后的几率比 5.7,95% CI,1.23-43.6]:患有 IBD 的妇女使用 HC 与出现 IBD 相关症状的可能性较低有关,但在一年内出现肠道炎症(FCAL>250 ug/g)的可能性较高。需要进一步研究这一二分法结果,可能需要研究使用碳氢化合物的持续时间和碳氢化合物的类型等方面。
Hormonal Contraceptives Reduce Active Symptomatic Disease but May Increase Intestinal Inflammation in IBD.
Background: Among women of reproductive age with inflammatory bowel disease (IBD), we aimed to assess the relationship of hormonal contraceptives (HCs) with IBD-related symptoms, and intestinal inflammation.
Methods: A nested cohort of women in the longitudinal Manitoba Living with IBD Study, ages 18 to 49, were followed for 1 year, with bi-weekly online surveys. This included a validated measure of disease activity; IBD Symptom Inventory (IBDSI), and stool samples obtained at 3 time-points for assessment of fecal calprotectin (FCAL). Use of HC included oral and vaginal intrauterine devices. Logistic regression analysis was used to assess the association between HC and IBD-related symptoms (IBDSI>14 for Crohn disease, >13 for ulcerative colitis), or inflammation (FCAL>250 ug/g) at any measurement point in the study.
Results: Of 71 women, 17 (24%) reported taking HC in the 1 year period. Adjusting for age, disease type, disease duration, and smoking status, the odds of having increased IBD-related symptoms (IBDSI) during the year were lower for women using HC compared with women not using HC [adjusted odds ratio 0.16, 95% CI, 0.02-0.90]. Conversely, women using HC were more likely to have inflammation during the year [adjusted odds ratio 5.7, 95% CI, 1.23-43.6].
Conclusions: HC use among women with IBD was associated with a lower likelihood of IBD-related symptoms but a higher likelihood of experiencing intestinal inflammation (FCAL>250 ug/g) over 1 year. Further work is needed to examine this dichotomous result, potentially examining aspects such as duration of HC use, and the types of HC.
期刊介绍:
Journal of Clinical Gastroenterology gathers the world''s latest, most relevant clinical studies and reviews, case reports, and technical expertise in a single source. Regular features include cutting-edge, peer-reviewed articles and clinical reviews that put the latest research and development into the context of your practice. Also included are biographies, focused organ reviews, practice management, and therapeutic recommendations.