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

      systematic-review

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          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.

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          Most cited references53

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2025)
          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
          Article 0 comments Cited 14069 times – based on 0 reviews     Review now
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            Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.

            Andreas Stang (2010)
            Article 0 comments Cited 4006 times – based on 0 reviews     Review now
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              Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies.

              Siew C. Ng, Hai Yun Shi, Nima Hamidi … (2017)
              Inflammatory bowel disease is a global disease in the 21st century. We aimed to assess the changing incidence and prevalence of inflammatory bowel disease around the world.
              Article 0 comments Cited 1526 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Neurol
                Journal ID (iso-abbrev): Front Neurol
                Journal ID (publisher-id): Front. Neurol.
                Title: Frontiers in Neurology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-2295
                Publication date (Electronic): 17 November 2023
                Publication date Collection: 2023
                Volume: 14
                Electronic Location Identifier: 1204727
                Affiliations
                [1] 1Department of Intensive Care Unit (ICU), Qian Jiang Central Hospital of Hubei Province, Qian Jiang Hospital Affiliated to Renmin Hospital of Wuhan University, Qian Jiang Clinical Medical College, Health Science Center, Yangtze University , Qianjiang, China
                [2] 2Department of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm , Yichang, China
                [3] 3Department of Ophthalmology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm , Yichang, China
                Author notes

                Edited by: Bernhard Sehm, University Hospital in Halle, Germany

                Reviewed by: Wei Yue, Tianjin Huanhu Hospital, China; Min Yuan, Jiangxi Provincial People's Hospital, China; Jiangwei Sun, Karolinska Institutet (KI), Sweden

                *Correspondence: Jin-Shan Fan gangsan0204@ 123456163.com
                Article
                DOI: 10.3389/fneur.2023.1204727
                PMC ID: 10693426
                PubMed ID: 38046580
                SO-VID: 91207a43-903b-4423-9712-9a13ea8a75b0
                Copyright © Copyright © 2023 Fan, Wang, Chen, Sun, Zhang, Li and Huang.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 12 April 2023
                Date accepted : 25 October 2023
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 55, Pages: 8, Words: 6402
                Funding
                This study was supported by the joint fund of Hubei Provincial Health Commission (No. WJ2019H570).
                Categories
                Subject: Neurology
                Subject: Systematic Review
                Custom metadata
                section-at-acceptance Stroke

                ScienceOpen disciplines: Neurology
                Keywords: ibd,stroke,risk,meta-analysis,systematic review
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: ibd, stroke, risk, meta-analysis, systematic review

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