Howel D, Fischbacher C M, Bhopal R S, Gray J, Metcalf J V, James O F
Department of Epidemiology and Public Health, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
Hepatology. 2000 May;31(5):1055-60. doi: 10.1053/he.2000.7050.
Primary biliary cirrhosis (PBC) is a disease of unknown etiology, with unexplained geographical variation. Various exposures have been suggested as triggers for disease development-possibly in susceptible individuals, but the evidence was not always well founded. We therefore conducted a population-based case-control study in Northeast England to investigate these and other exposures. All cases incident during 1993 to 1995 in a defined area of Northeast England were identified, and age- and sex-matched population controls were identified from primary care population registers. Cases and controls were sent postal self-completion questionnaires covering medical history and lifestyle. Information was received from 100 cases and 223 controls. The familial tendency of PBC was found to be less marked than has been claimed: Only weak associations were found with other autoimmune diseases. Among factors considered previously, no significant associations were found with surgical procedures, events in pregnancy, past infections, vaccinations, and medications. No significant associations were found for previously unconsidered lifestyle factors (drinking alcohol, previous pets, or stressful events), but there was an unexpected association with past smoking (ever smoked: 76% in cases vs. 57% in controls, odds ratio 2.4; smoked for 20 years or more: 64% vs. 35%, odds ratio 3.5). There were also unexpected significant associations with psoriasis (13% in cases vs. 3% in controls, odds ratio 4.6) and eczema (3% in cases vs. 11% in controls, odds ratio 0. 13). These findings merit further investigation.
原发性胆汁性肝硬化（PBC）是一种病因不明的疾病，存在无法解释的地域差异。各种暴露因素被认为可能是疾病发展的触发因素——可能是在易感个体中，但证据并不总是充分的。因此，我们在英格兰东北部进行了一项基于人群的病例对照研究，以调查这些及其他暴露因素。确定了1993年至1995年在英格兰东北部特定区域发病的所有病例，并从初级保健人群登记册中确定了年龄和性别匹配的人群对照。向病例和对照发送了涵盖病史和生活方式的邮政自填问卷。收到了100例病例和223例对照的信息。发现PBC的家族倾向不如所声称的那样明显：仅发现与其他自身免疫性疾病有微弱关联。在先前考虑的因素中，未发现与手术、妊娠事件、既往感染、疫苗接种和药物有显著关联。对于先前未考虑的生活方式因素（饮酒、既往养宠物或压力事件）未发现显著关联，但与既往吸烟存在意外关联（曾经吸烟：病例组为76% vs. 对照组为57%，比值比为2.4；吸烟20年或更长时间：64% vs. 35%，比值比为3.5）。还与银屑病（病例组为13% vs. 对照组为3%，比值比为4.6）和湿疹（病例组为3% vs. 对照组为11%，比值比为0.13）存在意外的显著关联。这些发现值得进一步研究。
