Epidemiology of irritable bowel syndrome and its associated factors in Saudi undergraduate students.
- 作者列表："AlButaysh OF","AlQuraini AA","Almukhaitah AA","Alahmdi YM","Alharbi FS
Background/Aim:Irritable bowel syndrome (IBS) is common among undergraduate students and is associated with several modifiable risk factors. The present study aimed to explore the epidemiology of IBS in Saudi undergraduate students. Materials and Methods:A cross-sectional study was carried out from February 2018 to June 2018. A total of 767 undergraduate students from all regions of Saudi Arabia completed an online self-administered questionnaire. IBS symptoms were assessed using the Rome IV diagnostic criteria. Results:The mean age was 21.88 years (range 18-29); 56.1% of the study population were females and 50.1% were from the central region of Saudi Arabia. Students of medical colleges represented 30.2% of the sample. The overall prevalence of IBS was 15.8%. Significant independent risk factors for IBS were female sex (OR = 3.738; 95% CI = 2.093, 6.673), being a student in a medical college (OR = 7.216; 95% CI = 4.438, 11.733), living in a rented apartment (OR = 6.752; 95% CI = 2.586, 17.627), living on campus (OR = 6.563; 95% CI = 2.138, 20.145), poor sleep quality (OR = 3.156; 95% CI = 1.850, 5.385), exercise (OR = 0.394; 95% CI = 0.193, 0.803), smoking (OR = 5.256; 95% CI = 2.841, 9.724), family history of IBS (OR = 1.641; 95% CI = 1.012, 2.661), and emotional stress (OR = 2.184; 95% CI = 1.375, 3.469). Conclusion:Overall, 15.8% of participants in this study met the Rome IV criteria for IBS diagnosis. IBS was associated with several lifestyle factors, as well as family history and emotional stress.
背景/目的: 肠易激综合征 (IBS) 在大学生中很常见，并且与几种可改变的危险因素相关。本研究旨在探讨沙特大学生 IBS 流行病学学。 材料与方法: 2018年2月至 2018年6月进行横断面研究。来自沙特阿拉伯所有地区的共有 767 名本科生完成了在线自填式问卷。使用罗马 IV 诊断标准评估 IBS 症状。 结果: 平均年龄 21.88 岁 (范围 18-29 岁); 56.1% 的研究人群为女性，50.1% 来自沙特阿拉伯中部地区。医学院的学生占样本的 30.2%。IBS 的总患病率为 15.8%。IBS 的独立危险因素为女性 (OR = 3.738; 95% CI = 2.093，6.673) 、在校大学生 (OR = 7.216; 95% CI = 4.438, 11.733) 、居住在租来的公寓 (OR = 6.752; 95% CI = 2.586，17.627) 、居住在校园 (OR = 6.563; 95% CI = 2.138，20.145) 、睡眠质量差 (OR = 3.156; 95% CI = 1.850，5.385) 、运动 (OR = 0.394; 95% CI = 0.193，0.803) 、吸烟 (OR = 5.256; 95% CI = 2.841，9.724) 、IBS 家族史 (OR = 1.641; 95% CI = 1.012，2.661) 和情绪压力 (OR = 2.184; 95% CI = 1.375，3.469)。 结论: 总体而言，本研究中 15.8% 的参与者符合 IBS 诊断的罗马 IV 标准。IBS 与几种生活方式因素，以及家族史和情绪压力有关。
METHODS::Chronic diseases, including inflammatory bowel disease (IBD) urgently need new biomarkers as a significant proportion of patients, do not respond to current medications. Inflammation is a common factor in these diseases and microbial sensing in the intestinal tract is critical to initiate the inflammation. We have identified ELMO1 (Engulfment and Cell Motility Protein-1) as a microbial sensor in epithelial and phagocytic cells that turns on inflammatory signals. Using a stem-cell-based "gut-in-a-dish" coculture model, we studied the interactions between microbes, epithelium and monocytes in the context of IBD. To mimic the in-vivo cell physiology, enteroid-derived monolayers (EDMs) were generated from the organoids isolated from WT and ELMO1-/- mice and colonic biopsies of IBD patients. The EDMs were infected with the IBD-associated microbes to monitor the inflammatory responses. ELMO1-depleted EDMs displayed a significant reduction in bacterial internalization, a decrease in pro-inflammatory cytokine productions and monocyte recruitment. The expression of ELMO1 is elevated in the colonic epithelium and in the inflammatory infiltrates within the lamina propria of IBD patients where the higher expression is positively correlated with the elevated expression of pro-inflammatory cytokines, MCP-1 and TNF-α. MCP-1 is released from the epithelium and recruits monocytes to the site of inflammation. Once recruited, monocytes require ELMO1 to engulf the bacteria and propagate a robust TNF-α storm. These findings highlight that the dysregulated epithelial ELMO1→MCP-1 axis can serve as an early biomarker in the diagnostics of IBD and other inflammatory disorders.
METHODS:BACKGROUND:Peripheral blood eosinophilia (PBE) is a biomarker of an aggressive multiyear natural history in adults with inflammatory bowel diseases (IBDs). Additionally, PBE at diagnosis is associated with higher disease activity in pediatric-onset IBD. We sought to determine if PBE can function as a biomarker of long-term disease severity in pediatric-onset IBD patients who are followed into adulthood. METHODS:We analyzed a consented, prospective, natural history IBD registry at an adult tertiary center from 2009 to 2018. Prevalence of PBE was evaluated in both pediatric- and adult-onset IBD patients. Demographics, clinical characteristics, and health care utilization data were compared in patients with and without PBE. RESULTS:Among 2800 adult IBD patients, 23.4% had pediatric-onset disease. PBE was found in 34% of the pediatric-onset patients compared with 26.8% of the adult-onset IBD patients (P < 0.001). In the pediatric-onset IBD cohort, PBE was associated with higher rates of allergies (P < 0.0001), but not of asthma, allergic rhinitis, or primary sclerosing cholangitis. In the adult IBD patients with pediatric-onset disease, PBE was associated with higher rates of C-reactive protein elevation (P < 0.0001), erythrocyte sedimentation rate elevation (P < 0.0001), higher health care utilization, and higher average health care charges per year (P < 0.00001). CONCLUSIONS:Peripheral blood eosinophilia was more prevalent in adult IBD patients with pediatric-onset compared with adult-onset disease. Among all IBD patients with long-term follow-up, PBE defined a subgroup with more severe illness. These data suggest that PBE may be a biomarker for a high-risk subgroup with high cost trajectory and long-term severity in pediatric-onset IBD that persists into adulthood.
METHODS::Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders with a complex pathogenesis, affecting people of all ages. They are characterized by alternating phases of clinical relapse and remission, depending on the fine balance between immune cells and the gut microbiota. The cross talk between cells of the immune system and the gut microbiota can result in either tolerance or inflammation, according to multifactorial triggers, ranging from environmental factors to genetic susceptibility. Glucocorticoid (GC) administration remains the first-line treatment for IBDs, although long-term use is limited by development of serious adverse effects. Recently, new alternative pharmacological therapies have been developed, although these are not always effective in IBD patients. There is a constant demand for effective new drug targets to guarantee total remission and improve the quality of life for IBD patients. The glucocorticoid-induced leucine zipper (GILZ) has been implicated as a promising candidate for this purpose, in view of its powerful anti-inflammatory effects that mimic those of GCs while avoiding their unwanted adverse reactions. Here we present and discuss the latest findings about the involvement of GILZ in IBDs.