Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Feb 05, 2024)
Date Submitted: Jun 30, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Ankylosing spondylitis Is Associated With an Increased Risk of Inflammatory Bowel Diseases: Analysis of the United Kingdom Biobank
ABSTRACT
Background:
Ankylosing spondylitis (AS) and inflammatory bowel diseases (IBDs) have been reported to correlated with each other in retrospective studies.
Objective:
Through a large sample size of Prospective cohort study to further support the relationship between Ankylosing spondylitis and Inflammatory bowel disease.
Methods:
The prospective associations between AS and Crohn’s disease(CD) or between AS and ulcerative colitis(UC) were analyzed with Cox regression models in prospective study cohorts, using data from the UK Biobank. We also calculated a polygenic risk score(PRS) for AS and analyzed its association with the risk of CD or UC. Finally, we used two-sample Mendelian randomization(MR) analyses to determine whether AS and IBDs have causal relationships on each other.
Results:
Participants with AS were at an over 7.8-fold risk of developing CD, and a 3.5-fold risk of CD. Reversely, the risk of AS in participants with CD(HR, 6.03; 95% CI, 3.10 ~ 11.73; P< 0.001) or with UC(HR, 3.08; 95% CI, 1.58 ~ 5.98; P< 0.001) were also greatly higher than the control population. These risks remained similar after adjusting for confounding factors in multivariate Cox models. Higher PRS of AS was also significantly association with increased risk of CD(HR, 3.60; 95% CI, 1.81~7.18; P<0.001) or UC(HR, 3.12; 95% CI, 1.92~5.08; P<0.001). In addition, the Mendelian analysis suggested a causal relationship of CD or UC on AS.
Conclusions:
AS and IBDs are associated with greatly increased risk of developing each other in the individual level. This bidirectional risk correlation should be of clinical attention.
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