Environmental risk factors in inflammatory bowel diseases. Investigating the hygiene hypothesis: A Spanish case-control study
Environmental risk factors in inflammatory bowel diseases. Investigating the hygiene hypothesis: A Spanish case-control study
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DOI：
10.3109/00365521.2010.510575
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发表时间：
2010-12-01
影响因子：
1.9
通讯作者：
Fernandez-Rodriguez, Conrado M.
中科院分区：
文献类型：
--
作者：
Lopez-Serrano, Pilar;Perez-Calle, Jose L.;Fernandez-Rodriguez, Conrado M.
目标。环境因素与炎症性肠病（IBD）的病因有关，但卫生假说的证据尚不清楚。我们调查了早期感染相关暴露与IBD风险之间的关系。患者和方法。开展了一项以医院为基础的病例对照研究。共有124例克罗恩病（CD）和146例溃疡性结肠炎（UC），分别与235例和278例匹配良好的对照组进行比较。采用IBD家族史、童年情况、家庭社会经济状况问卷调查。结果。在一个多变量模型中，生活在城市地区（优势比（OR） 4.58 (95% CI 2.17-10)），高教育水平（OR 1.83 (95% CI 14-2.95)）和社会地位（OR 1.68 (95% CI 1.2-2.35)）是CD的危险因素，而儿童呼吸道感染（OR 0.35 (95% CI 0.23-0.52)）和胃肠炎（OR 0.55 (95% CI 0.36-0.85)）是保护因素。居住在城市地区（OR 4.6 (95% CI 2.29-9.9)）、高教育水平（OR 10.3 (95% CI 2.54-42.1)）和社会地位（OR 2.042 (95% CI 1.31-3.17)）也是UC的危险因素，而呼吸道感染（OR 0.42 (95% CI 0.29-0.6)）和肠胃炎（OR: 0.6 (95% CI 0.42-0.86)）是UC的保护因素。阑尾切除术（OR 0.173 (95% CI 0.06-0.52)）和当前吸烟（OR 0.75 (95% CI 0.59-0.96)）也对UC具有保护作用。结论。这些结果进一步支持了儿童时期良好的生活条件与IBD风险增加相关的假设，并强化了吸烟与阑尾切除术和UC风险之间的负相关。
Objective. Environmental factors have been implicated in the etiology of inflammatory bowel disease (IBD), but evidence for the hygiene hypothesis is unclear. We investigated the relationship between early-life infection-related exposures and risk of IBD. Patients and methods. A hospital-based case-control study was carried out. A total of 124 cases of Crohn's disease (CD) and 146 of ulcerative colitis (UC) were compared with 235 and 278 well-matched control subjects, respectively. A multi-item questionnaire on familial history of IBD, childhood circumstances and familial socioeconomic status was carried out. Results. In a multivariate model, living in urban areas (odds ratio (OR) 4.58 (95% CI 2.17-10)), high educational level (OR 1.83 (95% CI 14-2.95)) and social status (OR 1.68 (95% CI 1.2-2.35)) were risk factors for CD, whereas childhood respiratory infections (OR 0.35 (95% CI 0.23-0.52)) and gastroenteritis (OR 0.55 (95% CI 0.36-0.85)) were protective factors. Living in urban areas (OR 4.6 (95% CI 2.29-9.9)), a high educational level (OR 10.3 (95% CI 2.54-42.1)) and social status (OR 2.042 (95% CI 1.31-3.17)) were also risk factors for UC, whereas respiratory infections (OR 0.42 (95% CI 0.29-0.6)) and gastroenteritis (OR: 0.6 (95% CI 0.42-0.86)) were protective factors. Appendectomy (OR 0.173 (95% CI 0.06-0.52)) and current smoking (OR 0.75 (95% CI 0.59-0.96)) were also protective for UC. Conclusion. These results further support the hypothesis that better living conditions during childhood are associated with an increased risk for IBD, and reinforce the negative association between smoking and appendectomy and the risk of UC.