Environmental risk factors in paediatric inflammatory bowel diseases: a population based case control study
Environmental risk factors in paediatric inflammatory bowel diseases: a population based case control study
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DOI：
10.1136/gut.2004.054353
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发表时间：
2005-03-01
期刊：
影响因子：
24.5
通讯作者：
Colombel, JF
中科院分区：
文献类型：
--
作者：
Baron, S;Turck, D;Colombel, JF
背景资料：早期环境暴露与炎症性肠病的病因学有关。目的：在一项基于儿科人群的病例对照研究中，检查炎症性肠病发生前的环境危险因素。方法：1988年1月至1989年12月期间，共有222例克罗恩病和60例溃疡性结肠炎发生在17岁之前根据性别、年龄和地理位置，将1997名受试者与一名对照受试者相匹配。我们在调查问卷中记录了140个研究变量，包括炎症性肠病家族史、围产期事件、婴儿和儿童饮食、疫苗接种和儿童疾病、家庭设施和家庭的社会经济地位。在多变量模型中，炎症性肠病家族史（比值比（OR）4.3（95%置信区间2.3 - 8）），母乳喂养（OR 2.1（1.3 - 3.4）），卡介苗接种（OR 3.6（1.1 - 11.9）），和湿疹病史（OR 2.1（1 - 4.5））是克罗恩病的显著危险因素，而经常饮用自来水是保护因素（OR 0.56（0.3 - 1））。炎症性肠病家族史（OR 12.5（2.2 - 71.4）），妊娠期疾病（OR 8.9（1.5 - 52）），以及卧室共用（OR 7.1（1.9 - 27.4））是溃疡性结肠炎的危险因素，而阑尾切除术是保护因素结论：虽然家族史和阑尾切除术是已知的危险因素，但基于家庭性乱、某些疫苗接种和饮食因素的风险变化可能提供新的病因学线索。
Background: Environmental exposures in early life have been implicated in the aetiology of inflammatory bowel disease.Objective: To examine environmental risk factors prior to the development of inflammatory bowel disease in a paediatric population based case control study.Methods: A total of 222 incident cases of Crohn's disease and 60 incident cases of ulcerative colitis occurring before 17 years of age between January 1988 and December 1997 were matched with one control subject by sex, age, and geographical location. We recorded 140 study variables in a questionnaire that covered familial history of inflammatory bowel disease, events during the perinatal period, infant and child diet, vaccinations and childhood diseases, household amenities, and the family's socioeconomic status.Results: In a multivariate model, familial history of inflammatory bowel disease ( odds ratio ( OR) 4.3 (95% confidence interval 2.3 - 8)), breast feeding ( OR 2.1 (1.3 - 3.4)), bacille Calmette-Guerin vaccination ( OR 3.6 (1.1 - 11.9)), and history of eczema ( OR 2.1 ( 1 - 4.5)) were significant risk factors for Crohn's disease whereas regular drinking of tap water was a protective factor ( OR 0.56 (0.3 - 1)). Familial history of inflammatory bowel disease ( OR 12.5 ( 2.2 - 71.4)), disease during pregnancy ( OR 8.9 ( 1.5 - 52)), and bedroom sharing ( OR 7.1 (1.9 - 27.4)) were risk factors for ulcerative colitis whereas appendicectomy was a protective factor ( OR 0.06 ( 0.01 - 0.36)).Conclusions: While family history and appendicectomy are known risk factors, changes in risk based on domestic promiscuity, certain vaccinations, and dietary factors may provide new aetiological clues.