Irritable Bowel Syndrome and Risk of Parkinson's Disease in Finland: A Nationwide Registry-Based Cohort Study

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http://hdl.handle.net/10138/336589

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Mertsalmi , TH , But , A , Pekkonen , E & Scheperjans , F 2021 , ' Irritable Bowel Syndrome and Risk of Parkinson's Disease in Finland: A Nationwide Registry-Based Cohort Study ' , Journal of Parkinson's disease , vol. 11 , no. 2 , pp. 641-651 . https://doi.org/10.3233/JPD-202330

Title: Irritable Bowel Syndrome and Risk of Parkinson's Disease in Finland: A Nationwide Registry-Based Cohort Study
Author: Mertsalmi, TH; But, A; Pekkonen, E; Scheperjans, F
Other contributor: University of Helsinki, HUS Neurocenter
University of Helsinki, Department of Public Health
University of Helsinki, HUS Neurocenter
University of Helsinki, Clinicum





Date: 2021
Language: eng
Number of pages: 11
Belongs to series: Journal of Parkinson's disease
ISSN: 1877-7171
DOI: https://doi.org/10.3233/JPD-202330
URI: http://hdl.handle.net/10138/336589
Abstract: Background: The gastrointestinal tract is considered as a potential origin of Parkinson's disease (PD) pathology. Besides constipation, appendectomy and inflammatory bowel disease have also been associated with a higher PD-risk, but findings have been inconsistent. To date, there is only one previous study suggesting that irritable bowel syndrome (IBS) is associated with an increased risk of PD. Objective: To evaluate whether IBS is associated with a higher risk of PD. Methods: In this retrospective registry-based cohort study, we identified 28,150 patients that were diagnosed with IBS (IBS+) during the years 1998-2014, using data from the Finnish Care Register for Health Care. In addition, 98,789 IBS-free reference subjects (IBS-) of same age and gender and living in the same municipality were included. The study subjects were followed until the end of the year 2014 to analyze the incidence of PD. The association between IBS and PD was assessed by a Cox proportional hazards model. Results: Diagnosis of IBS was associated with a higher hazard of PD with an adjusted hazard ratio (aHR) of 1.70 (95% CI 1.27-2.26). However, the ratio of hazard rates for PD between IBS+ and IBS- subjects was not constant over time. The Cox model with time-varying coefficient for IBS status showed that the hazard of PD was significantly higher in IBS patients only during the first two years of follow-up (aHR 2.96, 95% CI 1.78-4.92). Conclusion: Our findings indicate that the association between IBS and PD is likely explained by reverse causation and detection bias. It remains open whether IBS is an actual risk factor or a prodromal symptom of PD.
Subject: Parkinson's disease
irritable bowel syndrome
gastrointestinal tract
epidemiology
CONSTIPATION
SYMPTOMS
BIAS
3124 Neurology and psychiatry
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