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Частота сочетания функциональной диспепсии и синдрома раздраженного кишечника: метаанализ исследований с использованием римских критериев III–IV пересмотра
Частота сочетания функциональной диспепсии и синдрома раздраженного кишечника: метаанализ исследований с использованием римских критериев III–IV пересмотра
Андреев Д.Н., Бордин Д.С., Вьючнова Е.С., Лебедева Е.Г., Дичева Д.Т., Умярова Р.М., Маев И.В. Частота сочетания функциональной диспепсии и синдрома раздраженного кишечника: метаанализ исследований с использованием римских критериев III–IV пересмотра. Терапевтический архив. 2022;94(9):1099–1108. DOI: 10.26442/00403660.2022.09.201849
© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.
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Аннотация
Цель. Систематизировать данные о распространенности сочетания функциональной диспепсии (ФД) и синдрома раздраженного кишечника (СРК) при использовании Римских критериев III–IV пересмотра.
Материалы и методы. Поиск исследований проводился в электронных базах данных MEDLINE/PubMed, EMBASE, Cochrane. Глубина поиска составила 17 лет (с января 2006 по май 2022 г.). В финальный анализ отбирались оригинальные публикации из периодических рецензируемых изданий, в которых применялись Римские критерии III–IV пересмотра в качестве метода постановки диагноза ФД и СРК во взрослой популяции пациентов с подробной описательной статистикой, позволяющей включить результирующие данные в метаанализ.
Результаты. В итоговый анализ включено 38 исследований с участием 17 993 пациентов с ФД и 15 883 пациентов с СРК. В общем пуле исследований с применением Римских критериев III–IV пересмотра обобщенная распространенность ФД у пациентов с СРК составила 34,625% (95% доверительный интервал – ДИ 28,159–41,390), а обобщенная частота СРК у пациентов с ФД – 37,549% (95% ДИ 31,511–43,787). При анализах использовалась модель случайного эффекта, так как выявлена значительная гетерогенность между результатами (p<0,0001; I2>98%). При использовании Римских критериев III пересмотра обобщенная распространенность ФД у пациентов с СРК составила 31,993% (95% ДИ 26,135–38,150; I2=98,17%), тогда как частота СРК у пациентов с ФД – 34,694% (95% ДИ 29,319–40,273; I2=97,89%). Анализ работ с использованием Римских критериев IV пересмотра продемонстрировал, что обобщенная распространенность ФД у пациентов с СРК составила 42,614% (95% ДИ 18,588–68,675; I2=98,97%), а частота СРК у пациентов с ФД – 50,444% (95% ДИ 37,956–62,904; I2=94,39%).
Заключение. Настоящий метаанализ продемонстрировал, что распространенность сочетания ФД и СРК при использовании Римских критериев III–IV пересмотра достаточно высока и регистрируется примерно у каждого 3-го пациента с рассматриваемыми функциональными заболеваниями желудочно-кишечного тракта. При этом частота сочетания ФД и СРК при использовании Римских критериев IV пересмотра как минимум на 10% выше, чем при использовании критериев Рим-III.
Ключевые слова: функциональная диспепсия, синдром раздраженного кишечника, перекрест, сочетание, overlap
Materials and methods. A search in electronic databases MEDLINE/PubMed, EMBASE, and Cochrane was conducted. The depth of search was 17 years (from January 2006 to May 2022). Original publications from peer-reviewed periodicals that applied the Rome III–IV Criteria for diagnosis of FD and IBS in an adult patient population with detailed descriptive statistics to allow the resulting data to be included in the meta-analysis were selected for final analysis.
Results. The final analysis included 38 studies involving 17,993 patients with FD and 15,883 patients with IBS. In the overall pool of studies using the Rome III–IV Criteria, the pooled prevalence of FD in patients with IBS was 34.625% (95% confidence interval [CI] 28.159–41.390), and the pooled prevalence of IBS in patients with FD was 37.549% (95% [CI] 31.511–43.787). A random-effects model was used in the analyses since significant heterogeneity between results was found (p<0.0001; I2>98%). Using the Rome III Criteria, the pooled prevalence of FD in patients with IBS was 31.993% (95% CI 26.135–38.150; I2=98.17%), while the prevalence of IBS in patients with FD was 34.694% (95% [CI] 29.319–40.273; I2=97,89%). An analysis of papers using the Rome IV Criteria demonstrated that the pooled prevalence of FD in patients with IBS was 42.614% (95% CI 18.588–68.675; I2=98.97%), and the prevalence of IBS in patients with FD was 50.444% (95% CI 37.956–62.904; I2=94,39%).
Conclusion. This meta-analysis demonstrated that the prevalence of the combination of FD and IBS identified using the Rome III–IV Criteria is high and is reported in approximately 1 in 3 patients with the functional gastrointestinal disorders concerned. The prevalence of a combination of FD and IBS identified using the Rome IV Criteria is at least 10% higher than that using the Rome III Criteria.
Keywords: functional dyspepsia, irritable bowel syndrome, crossover, combination, overlap
Материалы и методы. Поиск исследований проводился в электронных базах данных MEDLINE/PubMed, EMBASE, Cochrane. Глубина поиска составила 17 лет (с января 2006 по май 2022 г.). В финальный анализ отбирались оригинальные публикации из периодических рецензируемых изданий, в которых применялись Римские критерии III–IV пересмотра в качестве метода постановки диагноза ФД и СРК во взрослой популяции пациентов с подробной описательной статистикой, позволяющей включить результирующие данные в метаанализ.
Результаты. В итоговый анализ включено 38 исследований с участием 17 993 пациентов с ФД и 15 883 пациентов с СРК. В общем пуле исследований с применением Римских критериев III–IV пересмотра обобщенная распространенность ФД у пациентов с СРК составила 34,625% (95% доверительный интервал – ДИ 28,159–41,390), а обобщенная частота СРК у пациентов с ФД – 37,549% (95% ДИ 31,511–43,787). При анализах использовалась модель случайного эффекта, так как выявлена значительная гетерогенность между результатами (p<0,0001; I2>98%). При использовании Римских критериев III пересмотра обобщенная распространенность ФД у пациентов с СРК составила 31,993% (95% ДИ 26,135–38,150; I2=98,17%), тогда как частота СРК у пациентов с ФД – 34,694% (95% ДИ 29,319–40,273; I2=97,89%). Анализ работ с использованием Римских критериев IV пересмотра продемонстрировал, что обобщенная распространенность ФД у пациентов с СРК составила 42,614% (95% ДИ 18,588–68,675; I2=98,97%), а частота СРК у пациентов с ФД – 50,444% (95% ДИ 37,956–62,904; I2=94,39%).
Заключение. Настоящий метаанализ продемонстрировал, что распространенность сочетания ФД и СРК при использовании Римских критериев III–IV пересмотра достаточно высока и регистрируется примерно у каждого 3-го пациента с рассматриваемыми функциональными заболеваниями желудочно-кишечного тракта. При этом частота сочетания ФД и СРК при использовании Римских критериев IV пересмотра как минимум на 10% выше, чем при использовании критериев Рим-III.
Ключевые слова: функциональная диспепсия, синдром раздраженного кишечника, перекрест, сочетание, overlap
________________________________________________
Materials and methods. A search in electronic databases MEDLINE/PubMed, EMBASE, and Cochrane was conducted. The depth of search was 17 years (from January 2006 to May 2022). Original publications from peer-reviewed periodicals that applied the Rome III–IV Criteria for diagnosis of FD and IBS in an adult patient population with detailed descriptive statistics to allow the resulting data to be included in the meta-analysis were selected for final analysis.
Results. The final analysis included 38 studies involving 17,993 patients with FD and 15,883 patients with IBS. In the overall pool of studies using the Rome III–IV Criteria, the pooled prevalence of FD in patients with IBS was 34.625% (95% confidence interval [CI] 28.159–41.390), and the pooled prevalence of IBS in patients with FD was 37.549% (95% [CI] 31.511–43.787). A random-effects model was used in the analyses since significant heterogeneity between results was found (p<0.0001; I2>98%). Using the Rome III Criteria, the pooled prevalence of FD in patients with IBS was 31.993% (95% CI 26.135–38.150; I2=98.17%), while the prevalence of IBS in patients with FD was 34.694% (95% [CI] 29.319–40.273; I2=97,89%). An analysis of papers using the Rome IV Criteria demonstrated that the pooled prevalence of FD in patients with IBS was 42.614% (95% CI 18.588–68.675; I2=98.97%), and the prevalence of IBS in patients with FD was 50.444% (95% CI 37.956–62.904; I2=94,39%).
Conclusion. This meta-analysis demonstrated that the prevalence of the combination of FD and IBS identified using the Rome III–IV Criteria is high and is reported in approximately 1 in 3 patients with the functional gastrointestinal disorders concerned. The prevalence of a combination of FD and IBS identified using the Rome IV Criteria is at least 10% higher than that using the Rome III Criteria.
Keywords: functional dyspepsia, irritable bowel syndrome, crossover, combination, overlap
Полный текст
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Авторы
Д.Н. Андреев*1, Д.С. Бордин1–3, Е.С. Вьючнова1, Е.Г. Лебедева1, Д.Т. Дичева1, Р.М. Умярова1, И.В. Маев1
1ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия;
2ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия;
3ФГБОУ ВО «Тверской государственный медицинский университет» Минздрава России, Тверь, Россия
*dna-mit8@mail.ru
1 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
2 Loginov Moscow Clinical Scientific Center, Moscow, Russia;
3 Tver State Medical University, Tver, Russia
*dna-mit8@mail.ru
1ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия;
2ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия;
3ФГБОУ ВО «Тверской государственный медицинский университет» Минздрава России, Тверь, Россия
*dna-mit8@mail.ru
________________________________________________
1 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia;
2 Loginov Moscow Clinical Scientific Center, Moscow, Russia;
3 Tver State Medical University, Tver, Russia
*dna-mit8@mail.ru
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