Reif S, Lavy A, Keter D, Fich A, Eliakim R, Halak A, Broide E, Niv Y, Ron Y, Patz J, Odes S, Villa Y, Gilat T
Department of Gastroenterology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Am J Gastroenterol. 2000 Feb;95(2):474-8. doi: 10.1111/j.1572-0241.2000.01771.x.
The association between smoking and inflammatory bowel disease (IBD) is well established, but data in Jewish patients in Israel were discrepant. The aim of this study was to examine the smoking habits of Jewish IBD patients in Israel in a large scale, multicenter study.
Patients with established IBD aged 18-70 yr were interviewed in relation to smoking and other habits. Two controls (one clinic and one neighborhood control matched by age, sex, community group, and education) were sought for each subject.
A total of 534 patients (273 ulcerative colitis [UC], and 261 Crohn's disease [CD]), along with 478 clinic controls and 430 neighborhood controls, were interviewed. There was no significant difference in the smoking habits between CD patients and their controls. Of patients with CD, 24.5% were current smokers, as compared to 19.9% of clinic controls and 25.2% of neighborhood controls (NS). The odds ratio for CD in current smokers was 1.30 (95% confidence interval 0.85-1.99) versus clinic controls, and 0.96 (0.63-1.46) versus neighborhood controls. There were also no significant differences in the proportion of ex-smokers between the groups. Only 12.9% of UC patients were current smokers versus 21.9. % Clinic controls, and 26.4% community controls (p<0.005). The proportions of ex-smokers were higher in UC patients 29.7% versus 25.9%, and 19.5% in their respective controls (p<0.001 vs. community controls). No significant differences were found in the proportions of never-smokers between IBD patients and controls. All the above trends were similar in four different parts of the country. The proportion of current smokers in UC decreased with the extent of disease (19.7% in proctitis, 13.6% in left-sided, and 4.5% in total colitis) (p<0.05). Patients with UC were more likely to be light smokers(1-10 cigarettes/day), whereas patients with CD were more likely to be moderate smokers (11-20 cigarettes/day) in comparison to their controls.
The lack of association between smoking and CD has now been established in Jewish patients in Israel. The association was found in UC. The stronger genetic tendency in CD may contribute to this discrepancy.
吸烟与炎症性肠病（IBD）之间的关联已得到充分证实，但以色列犹太患者的数据存在差异。本研究的目的是在一项大规模、多中心研究中调查以色列犹太IBD患者的吸烟习惯。
对年龄在18 - 70岁的确诊IBD患者进行了关于吸烟及其他习惯的访谈。为每位受试者寻找两名对照（一名诊所对照和一名按年龄、性别、社区组和教育程度匹配的邻里对照）。
共访谈了534例患者（273例溃疡性结肠炎[UC]和261例克罗恩病[CD]），以及478名诊所对照和430名邻里对照。CD患者与其对照之间的吸烟习惯无显著差异。CD患者中，24.5%为当前吸烟者，诊所对照为19.9%（非显著性差异），邻里对照为25.2%（非显著性差异）。当前吸烟者患CD的比值比相对于诊所对照为1.30（95%置信区间0.85 - 1.99），相对于邻里对照为0.96（0.63 - 1.46）。两组之间既往吸烟者的比例也无显著差异。UC患者中只有12.9%为当前吸烟者，而诊所对照为21.9%，社区对照为26.4%（p<0.005）。UC患者中既往吸烟者的比例更高，为29.7%，而其相应对照分别为25.9%和19.5%（与社区对照相比，p<0.001）。IBD患者和对照之间从不吸烟者的比例无显著差异。在该国四个不同地区，上述所有趋势均相似。UC患者中当前吸烟者的比例随疾病范围而降低（直肠炎为19.7%，左侧结肠炎为13.6%，全结肠炎为4.5%）（p<0.05）。与对照相比，UC患者更可能是轻度吸烟者（每天1 - 10支烟），而CD患者更可能是中度吸烟者（每天11 - 20支烟）。
现已证实以色列犹太患者中吸烟与CD之间缺乏关联。在UC中发现了这种关联。CD中较强的遗传倾向可能导致了这种差异。
