Association between inflammatory bowel disease and chronic obstructive pulmonary disease: a systematic review and meta-analysis

Labarca G1, Drake L2, Horta G3, Jantz MA4, Mehta HJ4, Fernandez-Bussy S5, Folch E6, Majid A7, Picco M8. BMC Pulm Med. 2019 Oct 28;19(1):186. doi: 10.1186/s12890-019-0963-y.


Author information

Facultad de Medicina, Universidad San Sebastian, Lientur 1457, 4100000, Concepcion, Chile. glabarcat@gmail.com.

A.T. Still University Kirksville College of Osteopathic Medicine, Kirksville, MO, USA.

Division of Gastroenterology, Hospital Regional Grant Benavente, Concepcion, Chile.

Division of Pulmonary and Critical Care Medicine, University of Florida-Gainesville, Gainesville, USA.\

Division of Pulmonary and Critical Care Medicine Mayo Clinic Jacksonville, Florida, USA.

Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, USA.

Division of Thoracic surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, USA.

Division of Gastroenterology, Mayo Clinic Jacksonville, Florida, USA.


INTRODUCTION: There is evidence of an association between inflammatory bowel disease (IBD) and lung conditions such as chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis explored the risk of new onset IBD in patients with COPD and new onset COPD in IBD patients.

METHODS: We performed a systematic review of observational studies exploring the risk of both associations. Two independent reviewers explored the EMBASE, MEDLINE, LILACS and DOAJ databases, and the risk of bias was evaluated using the ROBBINS-I tool. Data from included studies was pooled in a random effect meta-analysis following a DerSimonian-Laird method. The quality of the evidence was ranked using GRADE criteria.

RESULTS: Four studies including a pooled population of 1355 new cases were included. We found association between new onset IBD in COPD population. The risk of bias was low in most of them. Only one study reported tobacco exposure as a potential confounding factor. The pooled risk ratio (RR) for a new diagnosis of IBD in COPD patients was 2.02 (CI, 1.56 to 2.63), I2 = 72% (GRADE: low). The subgroup analyses for Crohn's disease and ulcerative colitis yielded RRs of 2.29 (CI, 1.51 to 3.48; I2 = 62%), and 1.79 (CI, 1.39 to 2.29; I2 = 19%.), respectively.

DISCUSSION: According to our findings, the risk of new onset IBD was higher in populations with COPD compared to the general population without this condition. Based on our analysis, we suggest a potential association between IBD and COPD; however, further research exploring the potential effect of confounding variables, especially cigarette smoking, is still needed. REVIEW REGISTER: (PROSPERO: CRD42018096624).

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