Environmental factors in inflammatory bowel disease: A case-control study based on a Danish inception cohort |
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Authors: | Tanja Stenbaek Hansen Tine Jess Ida Vind Margarita Elkjaer Malene Fey Nielsen Michael Gamborg Pia Munkholm |
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Affiliation: | aGastrointestinal Unit, Medical Section, Herlev University Hospital, Statens Serum Institut, Copenhagen, Denmark;bInstitute of Preventive Medicine, Copenhagen University Hospital, Statens Serum Institut, Copenhagen, Denmark;cDepartment of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark |
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Abstract: | BackgroundThe role of environmental factors in development of inflammatory bowel disease (IBD) remains uncertain. The aim of the present study was to assess a number of formerly suggested environmental factors in a case-control study of an unselected and recently diagnosed group of patients with IBD and a control group of orthopaedic patients.MethodsA total of 123 patients diagnosed with Crohn's disease (CD) and 144 with ulcerative colitis (UC) in Copenhagen (2003–2004) were matched 1:1 on age and gender to 267 orthopaedic controls. Participants received a questionnaire with 87 questions concerning environmental factors prior to IBD/orthopaedic admission. Odds ratios (OR) were calculated by logistic regression.ResultsBeing breastfed > 6 months (OR, 0.50; 95% CI, 0.23–1.11) and undergoing tonsillectomy (OR, 0.49; 95% CI, 0.31–0.78) decreased the odds for IBD, whereas appendectomy decreased the odds for UC only (OR, 0.29; 95% CI, 0.12–0.71). Vaccination against pertussis (OR, 2.08; 95% CI, 1.07–4.03) and polio (OR, 2.38; 95% CI, 1.04–5.43) increased the odds for IBD, whereas measles infection increased the odds for UC (OR, 3.50; 95% CI, 1.15–10.6). Low consumption of fibres and high consumption of sugar were significantly associated with development of CD and UC. Smoking increased the risk for CD and protected against UC.ConclusionAmong Danish patients with CD and UC belonging to an unselected cohort, disease occurrence was found to be associated both with well-known factors such as smoking and appendectomy, and with more debated factors including breastfeeding, tonsillectomy, childhood vaccinations, childhood infections, and dietary intake of fibres and sugar. |
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Keywords: | Abbreviations: CD, Crohn's disease IBD, inflammatory bowel disease UC, ulcerative colitis |
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