A comprehensive assessment of environmental exposures among 1000 North American patients with primary sclerosing cholangitis, with and without inflammatory bowel disease
A comprehensive assessment of environmental exposures among 1000 North American patients with primary sclerosing cholangitis, with and without inflammatory bowel disease
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DOI：
10.1111/apt.13154
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发表时间：
2015-05-01
影响因子：
7.6
通讯作者：
Lazaridis, K. N.
中科院分区：
文献类型：
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作者：
Eaton, J. E.;Juran, B. D.;Lazaridis, K. N.
BackgroundThe关系之间的原发性硬化性胆管炎（PSC）和环境在很大程度上是未知的。AimTo验证协会在以前的研究报告，并确定新的环境暴露之间的PSC patients.MethodsWe进行了多中心，病例对照分析，利用自我管理的问卷调查。病例（n=1000）和对照组（n=663）之间的反应进行了比较，使用多变量logistic回归调整年龄和性别。该模型进一步分层的基础上炎症性肠病（IBD）的状态（IBD n=741没有IBD n=259）。结果吸烟与PSC只有当IBD存在（OR，0.5; 95%CI 0.4-0.7），但没有IBD的PSC患者（OR，0.9; 95%CI 0.7-1.2）。与对照组相比，患有PSC的女性（无论是否存在IBD）接受激素替代治疗的可能性较小（HRT; OR，0.5; 95% CI 0.4-0.7），并且更可能复发尿路感染（OR，1.6; 95% CI 1.2-2.3）。PSC患者无论性别或IBD状态如何，都不太可能吃鱼（OR，0.4; 95% CI 0.3-0.6）和烧烤/烤肉（OR，0.8; 95% CI 0.7-0.9）。相比之下，PSC患者和没有IBD更有可能消费牛排/汉堡，更做得好（OR，1.3; 95% CI 1.2-1.5）。PSC女性更容易复发尿路感染，接受HRT的可能性更小。与对照组相比，PSC患者的饮食摄入量和食物制备方法不同。
BackgroundThe relationships between primary sclerosing cholangitis (PSC) and the environment are largely unknown.AimTo validate associations reported in previous studies and to identify novel environmental exposures among PSC patients.MethodsWe performed a multicenter, case-control analysis utilising self-administered questionnaires. Responses between cases (n=1000) and controls (n=663) were compared using multivariable logistic regression adjusted for age and gender. The model was further stratified based on inflammatory bowel disease (IBD) status (with IBD n=741 without IBD n=259).ResultsSmoking was associated with PSC only when IBD was present (OR, 0.5; 95% CI 0.4-0.7) but not among those PSC patients without IBD (OR, 0.9; 95% CI 0.7-1.2). Compared to controls, women with PSC (irrespective of the presence of IBD) were less likely to have received hormone replacement therapy (HRT; OR, 0.5; 95% CI 0.4-0.7) and were more likely to have recurrent urinary tract infections (OR, 1.6; 95% CI 1.2-2.3). PSC patients regardless of gender or IBD status were less likely to eat fish (OR, 0.4; 95% CI 0.3-0.6) and grilled/barbecued meat (OR, 0.8; 95% CI 0.7-0.9). In contrast, PSC patients with and without IBD were more likely to consume steak/burgers that were more well done (OR, 1.3; 95% CI 1.2-1.5).ConclusionsIBD (rather than PSC) is associated with smoking. Women with PSC are more likely to have recurrent urinary tract infections and less likely to receive HRT. Dietary intake and methods of food preparation differ in PSC patients when compared to controls.