Season and region of birth as risk factors for coeliac disease a key to the aetiology?
Season and region of birth as risk factors for coeliac disease a key to the aetiology?
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DOI：
10.1136/archdischild-2015-310122
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发表时间：
2016-12-01
影响因子：
5.2
通讯作者：
Sandstrom, Olof
中科院分区：
文献类型：
--
作者：
Namatovu, Fredinah;Lindkvist, Marie;Sandstrom, Olof
背景腹腔疾病（CD）的发病率在近几十年来有所增加，其特征是根据性别，诊断时的年龄，出生年份，出生月份和出生地区的变化。遗传易感性和暴露于麸质是必要的因素，在CD病因，虽然有几个环境因素被认为是.Methods一个全国性的前瞻性队列纵向研究，包括1 912 204名儿童年龄0-14.9岁出生在瑞典1991年至2009年。共有6569名儿童被诊断为活检证实的CD从47个儿科部门。使用考克斯回归，我们研究了CD诊断与出生季节，出生地区和出生year.Results总的来说，CD风险较高的儿童出生在春季，夏季和秋季相比，在冬季出生的儿童：春季1.08（95% CI 1.01至1.16）、夏季1.10（95% CI 1.03至1.18）和秋季1.10（95% CI 1.02至1.18）的校正HR。与出生在瑞典北方的儿童相比，出生在南部的儿童患CD的风险最高，其次是瑞典中部。如果在春季出生，在< 2岁时诊断的儿童CD风险增加，而在2-14.9岁诊断的儿童夏季和秋季出生的风险增加。1991-1996年出生队列中，如果在春季出生，CD风险增加，对于1997-2002年出生队列，夏季和秋季出生的风险增加，至于2003年的出生组别，结论出生季节和出生地区与出生后第一个月发生CD的风险增加独立相关，也与第一个月发生CD的风险增加相关。15年的生活。感染负荷的季节性变化是可能的解释。
Background Coeliac disease ( CD) incidence has increased in recent decades, characterised by variations according to sex, age at diagnosis, year of birth, month of birth and region of birth. Genetic susceptibility and exposure to gluten are the necessary factors in CD aetiology, although several environmental factors are considered.Methods A nationwide prospective cohort longitudinal study was conducted consisting of 1 912 204 children aged 0-14.9 years born in Sweden from 1991 to 2009. A total of 6569 children were diagnosed with biopsy-verified CD from 47 paediatric departments. Using Cox regression, we examined the association between CD diagnosis and season of birth, region of birth and year of birth.Results Overall, CD risk was higher for children born during spring, summer and autumn as compared with children born during winter: adjusted HR for spring 1.08 ( 95% CI 1.01 to 1.16), summer 1.10 ( 95% CI 1.03 to 1.18) and autumn 1.10 ( 95% CI 1.02 to 1.18). Increased CD risk was highest if born in the south, followed by central Sweden when compared with children born in northern Sweden. Children diagnosed at < 2 years had an increased CD risk if born in spring while those diagnosed at 2-14.9 years the risk was increased for summer and autumn births. The birth cohort of 1991-1996 had increased CD risk if born during spring, for the 1997-2002 birth cohort the risk increased for summer and autumn births, while for the birth cohort of 2003-2009 the risk was increased if born during autumn.Conclusions Season of birth and region of birth are independently and jointly associated with increased risk of developing CD during the first 15 years of life. Seasonal variation in infectious load is the likely explanation.