Abstract：
Objectives: The primary aim was to determine the prevalence of gastrointestinal diseases in patients with chronic rhinosinusitis (CRS), utilizing the National Health Insurance Research Database (NHIRD) in Taiwan. Several studies have supported the existence of distinct immune patterns between the Asian and Western populations in CRS patients. Through the population-based case-control study, we could compare the differences between various regions and provide further treatment strategies for subsequent studies in Asian CRS patients. The secondary aim was to assess whether different types of CRS influence the correlation with specific GI diseases. Understanding how different phenotypes or endotypes of CRS may relate to distinct GI disease patterns could provide valuable insights into the underlying mechanisms and potential shared pathways between these conditions. Methods: We use the NHIRD in Taiwan. Newly diagnosed patients with CRS were selected between January 1, 2001 and December 31, 2017 as the case group, and the controls were defined as individuals without a history of CRS. Patients with CRS were divided into two groups: with nasal polyps and without nasal polyps. We also separated GI tract diseases into four groups based on their different pathophysiologies. Results: This study included 356,245 participants (CRS: 71,249 and control: 284,996). The results showed that CRS was significantly associated with some specific GI tract diseases, including acute/chronic hepatitis B, gastroesophageal reflux disease (GERD) with/without esophagitis, achalasia of cardia, peptic/gastrojejunal ulcer, Crohn\'s disease, and ulcerative colitis. In addition, when CRS was subcategorized into chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP), GERD with esophagitis and peptic ulcer were significantly associated with CRSsNP. Conclusions: A significant association between CRS and premorbid GI tract diseases has been identified. Remarkably, GERD with esophagitis and peptic ulcer were significantly associated with CRSsNP. The underlying mechanisms require further investigation and may lead to new treatments for CRS. Researchers can further investigate the mechanisms by referring to our classification method to determine the implications for diagnosis and treatment.
摘要：
目的：主要目的是确定慢性鼻-鼻窦炎（CRS）患者胃肠道疾病的患病率，利用台湾的国家健康保险研究数据库(NHIRD)。一些研究支持CRS患者中亚洲和西方人群之间存在不同的免疫模式。通过以人群为基础的病例对照研究,我们可以比较不同地区之间的差异,并为亚洲CRS患者的后续研究提供进一步的治疗策略.次要目的是评估不同类型的CRS是否影响与特定胃肠道疾病的相关性。了解CRS的不同表型或内生型可能与不同的胃肠道疾病模式有关，可以提供对这些疾病之间潜在机制和潜在共享途径的有价值的见解。方法：我们在台湾使用NHIRD。选取2001年1月1日至2017年12月31日初诊CRS患者为病例组,对照组被定义为没有CRS病史的个体。CRS患者分为两组：鼻息肉和无鼻息肉。我们还根据胃肠道疾病的不同病理生理将其分为四组。结果：这项研究包括356,245名参与者（CRS：71,249和对照组：284,996）。结果显示CRS与某些特定胃肠道疾病显著相关,包括急性/慢性乙型肝炎，胃食管反流病（GERD）伴/不伴食管炎，贲门失弛缓症,消化性/胃空肠溃疡，克罗恩病,和溃疡性结肠炎.此外,当CRS被细分为慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）和慢性鼻-鼻窦炎不伴鼻息肉（CRSsNP），GERD伴食管炎和消化性溃疡与CRSsNP显著相关。结论：已经确定CRS与病前胃肠道疾病之间存在显着关联。值得注意的是,GERD伴食管炎和消化性溃疡与CRSsNP显著相关。潜在的机制需要进一步研究，并可能导致新的CRS治疗。研究人员可以通过参考我们的分类方法进一步研究机制，以确定对诊断和治疗的影响。
