Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 17:14:1204727.
doi: 10.3389/fneur.2023.1204727. eCollection 2023.

Association between inflammatory bowel disease and risk of stroke: a systematic review and meta-analysis of cohort studies

Jin-Shan Fan  1 , Meng Wang  2 , Ni Chen  3 , Bai-Chao Sun  3 , Qi-Bing Zhang  2 , Yong Li  2 , Ming-Jie Huang  3
Affiliations

Association between inflammatory bowel disease and risk of stroke: a systematic review and meta-analysis of cohort studies

Jin-Shan Fan et al. Front Neurol. .

Abstract

Background/objectives: Recently, four meta-analyses have explored the association between inflammatory bowel disease (IBD) and the risk of stroke. These studies have demonstrated that people with IBD may be at an increased risk of stroke. However, some limitations such as high heterogeneity and the lack of uniformity in the types of research, especially the reuse of some sample sizes, cannot be neglected. These factors reduce the credibility of their research conclusions. Therefore, we conducted a meta-analysis to explore this possible association.

Methods: PubMed, Embase, and Web of Science were searched from inception to 30 June 2023. A random effects model with the generic inverse variance method was used in this meta-analysis. The Review Manager software was used to obtain all relative risks (RRs) and their 95% confidence intervals (CIs). Publication bias was tested, and sensitivity and subgroup analyses were conducted to explore possible heterogeneities.

Results: This meta-analysis included 12 cohort studies (involving 4,495,055 individuals). Meta-analysis of these data has shown that IBD was associated with an increased risk of stroke (RR = 1.19, 95%CI:1.14-1.24, p < 0.00001). Our results were stable and robust in subgroup and sensitivity analyses.

Conclusions: Our results suggest that IBD is associated with an increased risk of stroke. To reduce the incidence of stroke, patients with IBD are encouraged to undergo stroke risk assessments, especially for young female patients; assessing the risk of ischemic stroke is of particular importance. Prospective studies considering stroke subtypes, IBD severity and treatments, regions, and other confounding factors are needed to further explore the nature of each association.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022373656.

Keywords: IBD; meta-analysis; risk; stroke; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. (2021) 1:56–66. 10.1038/s41575-020-00360-x - DOI - PMC - PubMed
    1. Kotze PG, Underwood FE, Damião AOMC, Ferraz JGP, Saad-Hossne R, Toro M, et al. Progression of inflammatory bowel diseases throughout latin america and the caribbean: a systematic review. Clin Gastroenterol Hepatol. (2020) 2:304–12. 10.1016/j.cgh.2019.06.030 - DOI - PubMed
    1. Ng SC, Shi HY, Hamidi N, Underwood FE, Tang W, Benchimol EI, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. (2017) 10114:2769–78. 10.1016/S0140-6736(17)32448-0 - DOI - PubMed
    1. The The global regional and and national burden of inflammatory bowel disease in 195 countries and territories 1990-2017: 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 . Lancet Gastroenterol Hepatol. (2020) 1:17–30. 10.1016/S2468-1253(19)30333-4 - DOI - PMC - PubMed
    1. Global regional and and national burden of stroke and its risk factors 1990-2019: 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019 . Lancet Neurol. (2021) 10:795–820. 10.1016/S1474-4422(21)00252-0 - DOI - PMC - PubMed

Publication types

LinkOut - more resources