Geographical variability and environmental risk factors in inflammatory bowel disease
Geographical variability and environmental risk factors in inflammatory bowel disease
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DOI：
10.1136/gutjnl-2012-303661
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发表时间：
2013-04-01
期刊：
影响因子：
24.5
通讯作者：
Colombel, Jean-Frederic
中科院分区：
文献类型：
--
作者：
Ng, Siew C.;Bernstein, Charles N.;Colombel, Jean-Frederic
炎症性肠病 (IBD) 的流行病学随时间和地域的变化表明，环境因素在改变疾病表达方面发挥着重要作用。发展中国家疾病的出现表明流行病学的演变与生活方式的西化和工业化有关。已确定的最强的环境关联是吸烟和阑尾切除术，尽管两者都不能单独解释全球 IBD 发病率的变化。社会城市化与饮食变化、抗生素使用、卫生状况、微生物暴露和污染相关，被认为是 IBD 的潜在环境风险因素。不同地理区域和人群的社会经济地位变化可能会有所不同，因此，考虑适用于个体患者的危险因素的异质性非常重要。个人、家族、社区、国家和区域的环境危险因素都可能导致 IBD 的发病。 IBD的地理变异为研究人员调查可能的环境病因提供了线索。本综述旨在提供探索 IBD 地理变异性的文献更新，并探讨可能解释这种变异性的环境风险因素。
The changing epidemiology of inflammatory bowel disease (IBD) across time and geography suggests that environmental factors play a major role in modifying disease expression. Disease emergence in developing nations suggests that epidemiological evolution is related to westernisation of lifestyle and industrialisation. The strongest environmental associations identified are cigarette smoking and appendectomy, although neither alone explains the variation in incidence of IBD worldwide. Urbanisation of societies, associated with changes in diet, antibiotic use, hygiene status, microbial exposures and pollution have been implicated as potential environmental risk factors for IBD. Changes in socioeconomic status might occur differently in different geographical areas and populations and, consequently, it is important to consider the heterogeneity of risk factors applicable to the individual patient. Environmental risk factors of individual, familial, community-based, country-based and regionally based origin may all contribute to the pathogenesis of IBD. The geographical variation of IBD provides clues for researchers to investigate possible environmental aetiological factors. The present review aims to provide an update of the literature exploring geographical variability in IBD and to explore the environmental risk factors that may account for this variability.