Early Life Exposures as Risk Factors for Pediatric Eosinophilic Esophagitis
Early Life Exposures as Risk Factors for Pediatric Eosinophilic Esophagitis
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DOI：
10.1097/mpg.0b013e318290d15a
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发表时间：
2013-07-01
影响因子：
2.9
通讯作者：
Dellon, Evan S.
中科院分区：
文献类型：
--
作者：
Jensen, Elizabeth T.;Kappelman, Michael D.;Dellon, Evan S.
目的：对嗜酸性食管炎（EOE）的病因学研究很少。已证明早期接触会导致其他过敏性疾病，但尚未在EOE中评估其作用。本研究旨在探讨早期生活暴露为可能的危险因素发展EoE在儿科population.Methods：这是一个2阶段的病例对照研究进行了北卡罗来纳州大学。第一阶段包括通过认知访谈对早期生活暴露进行调查。在第二阶段，基于电话的问卷调查与EoE的情况下（n=31）和2组控制，胃食管反流病患者，和非综合征唇腭裂患者的兄弟姐妹（n=26）。不同的控制进行了探讨，以确定控制反映源人口的情况下。唇腭裂患者的唇腭裂被确定为更合适的对照人群。比值比进行计算，以评估早期生活暴露和儿童EOE.Results的发展之间的关联：早期生活暴露与儿童发病EOE. Results的发展的几率增加。婴儿期使用抗生素与EoE发生几率的6倍相关（95%置信区间1.7-20.8）。剖腹产，早产，配方奶粉或混合（婴儿配方奶粉和母乳）喂养也有发展EOE.Conclusions的几率增加的趋势：一些早期生活暴露可能与EOE的发展。这些都是潜在的可改变的风险因素，如果得到证实，将对提高对Eoe发病机制和疾病预防的理解产生影响。
Objectives:Few etiologic studies of eosinophilic esophagitis (EoE) have been conducted. Early life exposures have been shown to predispose to other allergic disease, but their role has not been assessed in EoE. The present study sought to explore early life exposures as possible risk factors for developing EoE in the pediatric population.Methods:This was a 2-phase case-control study conducted at the University of North Carolina. The first phase consisted of survey development for early life exposures via cognitive interview. In the second phase, a telephone-based questionnaire was administered to cases with EoE (n=31) and 2 sets of controls, patients with gastroesophageal reflux disease, and siblings of nonsyndromic cleft lip/palate patients (n=26 in each). Different controls were explored to identify controls reflective of the source population of the cases. Siblings of cleft lip/palate patients were identified as the more suitable control population. Odds ratios were calculated to evaluate the association between early life exposures and the development of pediatric EoE.Results:Early life exposures were associated with increased odds of developing pediatric-onset EoE. Antibiotic use in infancy was associated with 6 times the odds of having EoE (95% confidence interval 1.7-20.8). Cesarean delivery, preterm birth, and formula-only or mixed (infant formula and breast milk) feeding also have trends toward increased odds for developing EoE.Conclusions:A number of early life exposures may be associated with the development of EoE. These are potentially modifiable risk factors that if confirmed would have implications for improved understanding of EoE pathogenesis and disease prevention.