生命早期暴露因素与肠易激综合征的关联:基于人群的队列研究

doi:10.6040/j.issn.1671-7554.0.2026.0289

山东大学学报 (医学版) ›› 2026, Vol. 64 ›› Issue (9): 78-87.doi: 10.6040/j.issn.1671-7554.0.2026.0289

生命早期暴露因素与肠易激综合征的关联:基于人群的队列研究

汪筱涵^1,2,3*,钟扬^4,5*,陈浩^4,5,种微^1,2,3,邱成苗⁶,白浩^5,6,吕明^4,5,李乐平^1,2,3

1.山东第一医科大学附属省立医院胃肠外科, 山东济南 250021;2.山东省消化肿瘤转化医学工程实验室, 山东济南 250021;3.山东第一医科大学(山东省医学科学院)医学科学与技术创新中心, 山东济南 250117;4.山东大学齐鲁医学院公共卫生学院流行病与卫生统计学系, 山东济南 250012;5.山东大学齐鲁医院临床流行病学研究室, 山东济南 250012;6.山东大学齐鲁医院营养科, 山东济南 250012

出版日期:2026-09-10 发布日期:2026-09-09
通讯作者: 李乐平. E-mail:lileping@mail.sdu.edu.cn吕明. E-mail:lvming@sdu.edu.cn*共同第一作者
基金资助:
山东省高等学校青年创新团队发展计划(2022KJ187,2023KJ018)

Association of early-life exposure factors with irritable bowel syndrome: a population-based cohort study

WANG Xiaohan^1,2,3, ZHONG Yang^4,5, CHEN Hao^4,5, CHONG Wei^1,2,3, QIU Chengmiao⁶, BAI Hao^5,6, LYU Ming^4,5, LI Leping^1,2,3

1. Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
2. Shandong Provincial Laboratory of Translational Medicine Engineering for Digestive Tumors, Jinan 250021, Shandong, China;
3. Medical Science and Technology Innovation Center, Shandong First Medical University &
Shandong Academy of Medical Sciences, Jinan 250117, Shandong, China;
4. Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
5. Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
6. Department of Nutrition, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China

Online:2026-09-10 Published:2026-09-09

摘要/Abstract

摘要： 目的探讨生命早期暴露因素及其加权风险评分与肠易激综合征(irritable bowel syndrome, IBS)发生风险之间的关联。方法纳入468 709例英国生物样本库参与者。通过基线问卷收集生命早期暴露数据,包括母乳喂养、母亲孕期吸烟、多胎出生、童年时期是否被领养以及出生体质量。以IBS为结局,采用多重插补法处理缺失协变量后,首先分别采用logistic回归模型评估各生命早期暴露因素与IBS发生风险的关联;随后将母乳喂养、母亲孕期吸烟、多胎出生及出生体质量纳入多变量logistic回归模型,依据模型β系数构建生命早期暴露因素风险评分,并评估该风险评分与IBS发生风险的关联。结果在完全调整协变量后研究结果显示,生命早期暴露因素包括非母乳喂养(OR=1.12, 95%CI: 1.08~1.15)、母亲孕期吸烟(OR=1.11, 95%CI: 1.08~1.14)及低出生体质量(OR=1.16, 95%CI: 1.03~1.32)与IBS发生风险增加相关。与生命早期暴露因素风险评分较低的参与者(最低四分位组,Q1)相比,生命早期暴露因素风险评分较高的参与者(第三至第四分位组,Q3~Q4),其IBS风险分别增加11%和19%(Q3: OR=1.11, 95%CI: 1.06~1.17; Q4: OR=1.19, 95%CI: 1.14~1.25)。结论较重的生命早期不良暴露负担(加权风险评分较高)与随后IBS发生风险增加相关。从生命历程流行病学角度提示,针对生命早期的公共卫生与健康促进策略可能对降低IBS的远期疾病负担具有积极意义,未来研究可致力于验证生命早期暴露因素与IBS之间的因果关系。

关键词: 肠易激综合征, 生命早期暴露因素, 加权风险评分, 队列研究, 英国生物样本库

Abstract: Objective To explore the association of early-life exposure factors as well as their weighted risk scores, and the risk of developing irritable bowel syndrome(IBS). Methods The present study included a total of 468,709 participants from the UK Biobank, with information on early-life exposures-such as breastfeeding, maternal smoking around birth, multiple birth, adoption during childhood, and birthweight-collected via baseline questionnaire. Following multiple imputation of missing covariates, associations among the variables were assessed using logistic regression models with IBS as the outcome. The initial analysis examined the relationship between each individual early-life exposure and the risk of IBS. Subsequently, breastfeeding, maternal smoking around birth, multiple birth, and birthweight were included in a multivariable logistic regression model. An early-life exposure risk score was then constructed based on the models β coefficients, and its association with IBS risk was evaluated. Results A comprehensive adjustment for covariates revealed that early-life factors, encompassing non-breastfeeding(OR=1.12, 95%CI: 1.08-1.15), maternal smoking around birth(OR=1.11, 95%CI: 1.08-1.14), and low birth weight(OR=1.16, 95%CI: 1.03-1.32)were associated with increased risk of IBS. Furthermore, compared with participants with lower early-life exposure risk score(the lowest quartile, Q1), those with higher scores(the third and fourth quartiles, Q3-Q4)had an 11% and 19% higher risk of IBS, respectively(Q3: OR=1.11, 95%CI: 1.06-1.17; Q4: OR=1.19, 95%CI: 1.14-1.25). Conclusion A higher burden of adverse early-life exposures(indicated by a higher weighted risk score)is associated with a higher subsequent risk of IBS. From an epidemiological standpoint, these findings imply that public health and health promotion strategies targeting early life may have a beneficial effect on reducing the long-term burden of IBS. It is recommended that future research efforts concentrate on establishing the causal relationship between these early-life exposures and IBS.

Key words: Irritable bowel syndrome, Early-life exposures, Weighted risk score, Cohort study, UK Biobank

中图分类号:

R574.4

汪筱涵, 钟扬, 陈浩, 种微, 邱成苗, 白浩, 吕明, 李乐平. 生命早期暴露因素与肠易激综合征的关联:基于人群的队列研究[J]. 山东大学学报 (医学版), 2026, 64(9): 78-87.

WANG Xiaohan, ZHONG Yang, CHEN Hao, CHONG Wei, QIU Chengmiao, BAI Hao, LYU Ming, LI Leping. Association of early-life exposure factors with irritable bowel syndrome: a population-based cohort study[J]. Journal of Shandong University (Health Sciences), 2026, 64(9): 78-87.

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生命早期暴露因素与肠易激综合征的关联:基于人群的队列研究

Association of early-life exposure factors with irritable bowel syndrome: a population-based cohort study

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