Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Risk of inflammatory bowel disease in patients with chronic obstructive pulmonary disease: A nationwide, population-based study
Jooyoung Lee, Jong Pil Im, Kyungdo Han, Seona Park, Hosim Soh, Kukhwan Choi, Jihye Kim, Jaeyoung Chun, Joo Sung Kim
Jooyoung Lee, Joo Sung Kim, Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, South Korea
Jooyoung Lee, Jong Pil Im, Seona Park, Hosim Soh, Kukhwan Choi, Joo Sung Kim, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, South Korea
Kyungdo Han, Department of Biostatics, College of Medicine, Catholic University of Korea, Seoul 06591, South Korea
Jihye Kim, Department of Internal Medicine, CHA Gangnam Medical Center, CHA University, Seoul 06135, South Korea
Jaeyoung Chun, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, South Korea
Author contributions: Lee J, Han KD and Im JP design the research; Han KD, Park S, Soh H, and Choi K contributed in data acquisition; Lee J and Han KD contributed in data analysis and interpretation; Lee J and Im JP drafted the manuscript; Kim J, Chun J and Kim JS critically revised the manuscript; All authors approved the final manuscript.
Institutional review board statement: The study protocol was approved by the Seoul National University Hospital Institutional Review Board (H-1703-107-840).
Informed consent statement: All personal information was encrypted and all data were anonymous. And informed consent was waived by the Seoul National University Hospital Institutional Review Board because of retrospective study design.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jong Pil Im, MD, PhD, Professor, Doctor, Department of Internal Medicine and Liver Research Instititute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul 03080, South Korea. jpim0911@snu.ac.kr
Telephone: +82-2-20720638
Received: July 2, 2019
Peer-review started: July 2, 2019
First decision: August 2, 2019
Revised: September 18, 2019
Accepted: October 17, 2019
Article in press: October 17, 2019
Published online: November 14, 2019
ARTICLE HIGHLIGHTS
Research background
Inflammatory bowel disease (IBD) is known to be associated with airway disease and there is a growing evidence of increased risk of IBD among patients with chronic obstructive pulmonary disease (COPD).
Research motivation
South Korea has a considerably high prevalence of COPD and is one of the highest incidence of IBD among Asian countries. Previous western studies have reported the risk of IBD in COPD patients, however, no research based on Asian data has been reported.
Research objectives
To estimate the incidence of IBD in patients with COPD compared to non-COPD controls and the risk of IBD development according to COPD severity.
Research methods
From January 2010 and December 2014, patients with COPD were identified using International Classification of Disease, 10th revision (ICD-10 code) and prescription records from the National Health Insurance (NHI) database. The COPD patients were divided into the severe and the mild COPD group. And these patients were subsequently 1:5 matches with individuals without COPD. Newly diagnosed IBD patients with Crohn’s disease and ulcerative colitis were identified using ICD-10 code and the rare intractable disease registration program codes from NHI database. The risk of IBD in COPD patients compared to controls was analyzed by Cox proportional hazard regression models. The cumulative incidence of IBD were compared between the groups.
Research results
The COPD group had higher incidences of IBD compared to non-COPD controls and the risk of IBD in the COPD group was increased. The incidence rate of IBD was higher in the severe COPD group than in the mild COPD group.
Research conclusions
The incidences of IBD were significantly increased in COPD patients in South Korea and the risk of developing IBD also increased as the severity of COPD increased.
Research perspectives
Careful monitoring the gastrointestinal symptoms indicative of IBD in COPD patients is important. Accurate clinical assessment should be done, especially in patients with severe COPD in order to determine the best strategies to prevent complications.
