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Meta-Analysis
. 2019 Oct 28;19(1):186.
doi: 10.1186/s12890-019-0963-y.

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

Gonzalo Labarca  1 , Lauren Drake  2 , Gloria Horta  3 , Michael A Jantz  4 , Hiren J Mehta  4 , Sebastian Fernandez-Bussy  5 , Erik Folch  6 , Adnan Majid  7 , Michael Picco  8
Affiliations
Meta-Analysis

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

Gonzalo Labarca et al. BMC Pulm Med. .

Abstract

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).

Keywords: Chronic obstructive; Inflammatory bowel diseases; Lung diseases; Obstructive; Pulmonary disease.

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Conflict of interest statement

Authors declare no competing interests regarding this manuscript.

Figures

Fig. 1
Fig. 1
PRISMA Flow
Fig. 2
Fig. 2
Comparison 1. Risk of IBD in COPD patients and subgroup analysis according to Crohn’s disease (CD) or Ulcerative colitis (UC)
See this image and copyright information in PMC

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