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Early life environment and natural history of inflammatory bowel diseases
BACKGROUND: Early life exposures may modify risk of inflammatory bowel diseases (IBD; Crohn’s disease (CD), ulcerative colitis (UC)). However, the relationship between early life exposures and natural history of IBD has not been previously examined. METHODS: This single center study included patient...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300207/ https://www.ncbi.nlm.nih.gov/pubmed/25510175 http://dx.doi.org/10.1186/s12876-014-0216-8 |
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author | Guo, Abra Y Stevens, Betsy W Wilson, Robin G Russell, Caitlin N Cohen, Melissa A Sturgeon, Holly C Thornton, Anna Giallourakis, Cosmas Khalili, Hamed Nguyen, Deanna D Sauk, Jenny Yajnik, Vijay Xavier, Ramnik J Ananthakrishnan, Ashwin N |
author_facet | Guo, Abra Y Stevens, Betsy W Wilson, Robin G Russell, Caitlin N Cohen, Melissa A Sturgeon, Holly C Thornton, Anna Giallourakis, Cosmas Khalili, Hamed Nguyen, Deanna D Sauk, Jenny Yajnik, Vijay Xavier, Ramnik J Ananthakrishnan, Ashwin N |
author_sort | Guo, Abra Y |
collection | PubMed |
description | BACKGROUND: Early life exposures may modify risk of inflammatory bowel diseases (IBD; Crohn’s disease (CD), ulcerative colitis (UC)). However, the relationship between early life exposures and natural history of IBD has not been previously examined. METHODS: This single center study included patients with CD or UC recruited in a prospective IBD registry. Enrolled patients completed a detailed environmental questionnaire that assessed various early life environmental exposures. Our primary outcome was requirement for disease-related surgery in CD and UC. Logistic regression models defined independent effect of early life exposures, adjusting for potential confounders. RESULTS: Our study included 333 CD and 270 UC patients. Just over half were female with a median age at diagnosis of 25 years. One-third of the cohort had history of bowel surgery (31%) and nearly half had used at least one biologic agent (47%). Among those with CD, being breastfed was associated with reduced risk of CD-related surgery (34% vs. 55%), while childhood cigarette smoke exposure was associated with increased risk. On multivariate analysis, history of being breastfed (odds ratio (OR) 0.21, 95% confidence interval [CI] 0.09–0.46) and cigarette smoke exposure as a child (OR 2.17, 95% CI 1.10–4.29) remained independently associated with surgery. None of the early life variables influenced disease phenotype or outcome in UC. CONCLUSION: A history of being breastfed was associated with a decreased risk while childhood cigarette smoke exposure was associated with an increased risk of surgery in patients with CD. Further investigation to examine biological mechanisms is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-014-0216-8) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4300207 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43002072015-01-21 Early life environment and natural history of inflammatory bowel diseases Guo, Abra Y Stevens, Betsy W Wilson, Robin G Russell, Caitlin N Cohen, Melissa A Sturgeon, Holly C Thornton, Anna Giallourakis, Cosmas Khalili, Hamed Nguyen, Deanna D Sauk, Jenny Yajnik, Vijay Xavier, Ramnik J Ananthakrishnan, Ashwin N BMC Gastroenterol Research Article BACKGROUND: Early life exposures may modify risk of inflammatory bowel diseases (IBD; Crohn’s disease (CD), ulcerative colitis (UC)). However, the relationship between early life exposures and natural history of IBD has not been previously examined. METHODS: This single center study included patients with CD or UC recruited in a prospective IBD registry. Enrolled patients completed a detailed environmental questionnaire that assessed various early life environmental exposures. Our primary outcome was requirement for disease-related surgery in CD and UC. Logistic regression models defined independent effect of early life exposures, adjusting for potential confounders. RESULTS: Our study included 333 CD and 270 UC patients. Just over half were female with a median age at diagnosis of 25 years. One-third of the cohort had history of bowel surgery (31%) and nearly half had used at least one biologic agent (47%). Among those with CD, being breastfed was associated with reduced risk of CD-related surgery (34% vs. 55%), while childhood cigarette smoke exposure was associated with increased risk. On multivariate analysis, history of being breastfed (odds ratio (OR) 0.21, 95% confidence interval [CI] 0.09–0.46) and cigarette smoke exposure as a child (OR 2.17, 95% CI 1.10–4.29) remained independently associated with surgery. None of the early life variables influenced disease phenotype or outcome in UC. CONCLUSION: A history of being breastfed was associated with a decreased risk while childhood cigarette smoke exposure was associated with an increased risk of surgery in patients with CD. Further investigation to examine biological mechanisms is warranted. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12876-014-0216-8) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-16 /pmc/articles/PMC4300207/ /pubmed/25510175 http://dx.doi.org/10.1186/s12876-014-0216-8 Text en © Guo et al.; licensee BioMed Central. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Guo, Abra Y Stevens, Betsy W Wilson, Robin G Russell, Caitlin N Cohen, Melissa A Sturgeon, Holly C Thornton, Anna Giallourakis, Cosmas Khalili, Hamed Nguyen, Deanna D Sauk, Jenny Yajnik, Vijay Xavier, Ramnik J Ananthakrishnan, Ashwin N Early life environment and natural history of inflammatory bowel diseases |
title | Early life environment and natural history of inflammatory bowel diseases |
title_full | Early life environment and natural history of inflammatory bowel diseases |
title_fullStr | Early life environment and natural history of inflammatory bowel diseases |
title_full_unstemmed | Early life environment and natural history of inflammatory bowel diseases |
title_short | Early life environment and natural history of inflammatory bowel diseases |
title_sort | early life environment and natural history of inflammatory bowel diseases |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300207/ https://www.ncbi.nlm.nih.gov/pubmed/25510175 http://dx.doi.org/10.1186/s12876-014-0216-8 |
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