结肠炎对吸烟反应的性别差异。

Gender differences in the response of colitis to smoking.

作者信息

Cosnes Jacques, Nion-Larmurier Isabelle, Afchain Pauline, Beaugerie Laurent, Gendre Jean-Pierre

机构信息

Hôpital Saint-Antoine, 184 rue du Faubourg St-Antoine, 75571 Paris cedex 12, France.

出版信息

Clin Gastroenterol Hepatol. 2004 Jan;2(1):41-8. doi: 10.1016/s1542-3565(03)00290-8.

DOI:10.1016/s1542-3565(03)00290-8

PMID:15017631

Abstract

BACKGROUND AND AIMS

The aim of this study was to examine in parallel the effect of smoking on ulcerative colitis and Crohn's colitis and assess the effect of gender on the response of colitis to smoking.

METHODS

Medical charts of 1784 adult consecutive patients (978 patients, ulcerative colitis; 118 patients, indeterminate colitis; and 688 patients, Crohn's colitis), whose smoking habits were specified by direct interview, were reviewed.

RESULTS

The proportion of ever smokers was 42% in ulcerative colitis, 43% in indeterminate colitis, and 61% in Crohn's colitis. Smoking cessation preceded the onset of colitis in 279 patients with ulcerative colitis or indeterminate colitis (61%) and only 52 patients (12%) with Crohn's colitis. In ulcerative colitis and indeterminate colitis, current smoking delayed mean age at disease onset in men (from 32 to 41 yr; P < 0.001), but not women (from 33 to 33 yr), and decreased the need for immunosuppressants in men (10-yr cumulative risk, 26% +/- 4% in nonsmokers vs. 8% +/- 4% in smokers; P < 0.01), but not significantly in women. Conversely, in Crohn's colitis, current smoking hastened disease onset in women (from 35 to 29 yr; P < 0.001), but not men (from 32 to 31 yr), and increased the need for immunosuppressants in women (10-yr cumulative risk, 48% +/- 5% in nonsmokers vs. 58% +/- 4% in smokers; P < 0.01), but not men.

CONCLUSIONS

The dual effects of smoking in colitis, beneficial in ulcerative colitis and harmful in Crohn's colitis, are modulated importantly by gender, with women having more disadvantage than men.

摘要

背景与目的

本研究旨在同时考察吸烟对溃疡性结肠炎和克罗恩结肠炎的影响，并评估性别对结肠炎吸烟反应的影响。

方法

回顾了1784例成年连续患者（978例溃疡性结肠炎患者、118例未定型结肠炎患者和688例克罗恩结肠炎患者）的病历，这些患者的吸烟习惯通过直接访谈确定。

结果

溃疡性结肠炎患者中既往吸烟者的比例为42%，未定型结肠炎患者中为43%，克罗恩结肠炎患者中为61%。在279例溃疡性结肠炎或未定型结肠炎患者（61%）中，戒烟先于结肠炎发病，而在克罗恩结肠炎患者中只有52例（12%）。在溃疡性结肠炎和未定型结肠炎中，当前吸烟使男性疾病发病的平均年龄延迟（从32岁至41岁；P<0.001），但女性未延迟（从33岁至33岁），且男性对免疫抑制剂的需求减少（10年累积风险，非吸烟者为26%±4%，吸烟者为8%±4%；P<0.01），但女性无显著差异。相反，在克罗恩结肠炎中，当前吸烟使女性疾病发病加速（从35岁至29岁；P<0.001），但男性未加速（从32岁至31岁），且女性对免疫抑制剂的需求增加（10年累积风险，非吸烟者为48%±5%，吸烟者为58%±4%；P<0.01），但男性无此情况。