Environmental factors in inflammatory bowel disease:: A co-twin control study of a Swedish-Danish twin population
Environmental factors in inflammatory bowel disease:: A co-twin control study of a Swedish-Danish twin population
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DOI：
10.1097/01.mib.0000228998.29466.ac
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发表时间：
2006-10-01
影响因子：
4.9
通讯作者：
Jarnerot, Gunnar
中科院分区：
文献类型：
--
作者：
Halfvarson, Jonas;Jess, Tine;Jarnerot, Gunnar
背景：遗传和环境因素与炎症性肠病（IBD）的病因有关。我们研究了环境因素，在人口为基础的瑞典-丹麦双胞胎队列使用的co-twin control method.Subjects和方法：一份问卷被发送到317双胞胎对有关标志物的暴露在以下领域：感染/殖民化和饮食以及吸烟，阑尾切除术，口服避孕药。采用条件Logistic回归分析计算OR值。当混杂因素似乎合理时，添加多变量条件logistic回归。结果：问卷的回答率为83%。考虑到研究设计，仅纳入不一致对（克罗恩病[CD]，n = 102;溃疡性结肠炎[UC]，n = 125）。复发性胃肠道感染与UC（OR，8.0; 95%置信区间[CI]，1.0-64）和CD（OR，5.5; 95% CI，1.2-25）均相关。因胃肠道感染住院与CD相关（OR，12; 95% CI，1.6-92）。吸烟与UC呈负相关（OR，0.4; 95%CI，0.2-0.9），与CD相关（OR，2.9; 95%CL 1.2-7.1）。结论：观察到的相关性表明，可能的感染事件的标志物可能会影响IBD的风险。其中一些效应可能由肠道植物群的长期变化或对植物群的反应性改变介导。证实了吸烟对IBD的影响。
Background: Genetics and environmental factors are implicated in the etiology of inflammatory bowel disease (IBD). We studied environmental factors in a population-based Swedish-Danish twin cohort using the co-twin control method.Subjects and Methods: A questionnaire was sent to 317 twin pairs regarding markers of exposures in the following areas: infections/colonization and diet as well as smoking, appendectomy, and oral contraceptives. Odds ratios (OR) were calculated by conditional logistic regression. When confounding appeared plausible, multivariate conditional logistic regression was added. The questions were also divided into topic groups, and adjustment was made for multiple testing within each of the groups.Results: The response rate to the questionnaire was 83%. In consideration of the study design, only discordant pairs were included (Crohn's disease [CD], n = 102; ulcerative colitis [UC], n = 125). Recurrent gastrointestinal infections were associated with both UC (OR, 8.0; 95% confidence interval [CI], 1.0-64) and CD (OR, 5.5; 95% Cl, 1.2-25). Hospitalization for gastrointestinal infections was associated with CD (OR, 12; 95% CI, 1.6-92). Smoking was inversely associated with UC (OR, 0.4; 95% Cl, 0.2-0.9) and associated with CD (OR, 2.9; 95% CL 1.2-7.1).Conclusions: The observed associations indicate that markers of possible infectious events may influence the risk of IBD. Some of these effects might be mediated by long-term changes in gut flora or alterations in reactivity to the flora. The influence of smoking in IBD was confirmed.