Abubakar Ibrahim, Myhill Deborah J, Hart Andrew R, Lake Iain R, Harvey Ian, Rhodes Jonathan M, Robinson Richard, Lobo Alan J, Probert Christopher S J, Hunter Paul R
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, United Kingdom.
Am J Epidemiol. 2007 Apr 1;165(7):776-83. doi: 10.1093/aje/kwk067. Epub 2007 Jan 19.
Similarities between Johne's disease in ruminants and Crohn's disease in humans have led to speculation that Mycobacterium avium paratuberculosis (MAP) might be a causative agent in Crohn's disease. However, evidence remains inconsistent. In this case-control study (1999-2004), the authors assessed the possible role of drinking water and dairy products potentially contaminated with MAP in the etiology of Crohn's disease. A total of 218 patients with Crohn's disease recruited from nine hospitals in England and 812 controls recruited from the community completed a short questionnaire for evaluation of proxy measures of potential exposure to MAP. Logistic regression showed no significant association with measures of potential contamination of water sources with MAP, water intake, or water treatment. Multivariate analysis showed that consumption of pasteurized milk (per kg/month: odds ratio (OR) = 0.82, 95% confidence interval (CI): 0.69, 0.97) was associated with a reduced risk of Crohn's disease. Meat intake (per kg/month: OR = 1.40, 95% CI: 1.17, 1.67) was associated with a significantly increased risk of Crohn's disease, whereas fruit consumption (per kg/month: OR = 0.78, 95% CI: 0.67, 0.92) was associated with reduced risk. This study does not support a role for water or dairy products potentially contaminated with MAP in the etiology of Crohn's disease. The observed association with meat and the negative association with pasteurized milk need further study.
反刍动物的副结核与人类的克罗恩病之间存在相似之处，这引发了关于副结核分枝杆菌（MAP）可能是克罗恩病病原体的推测。然而，证据仍然不一致。在这项病例对照研究（1999 - 2004年）中，作者评估了可能被MAP污染的饮用水和乳制品在克罗恩病病因学中的潜在作用。从英国九家医院招募的218例克罗恩病患者和从社区招募的812名对照完成了一份简短问卷，以评估潜在接触MAP的替代指标。逻辑回归显示，与水源被MAP潜在污染的指标、饮水量或水处理之间无显著关联。多变量分析表明，食用巴氏杀菌牛奶（每千克/月：比值比（OR）= 0.82，95%置信区间（CI）：0.69，0.97）与克罗恩病风险降低相关。肉类摄入量（每千克/月：OR = 1.40，95% CI：1.17，1.67）与克罗恩病风险显著增加相关，而水果摄入量（每千克/月：OR = 0.78，95% CI：0.67，0.92）与风险降低相关。这项研究不支持可能被MAP污染的水或乳制品在克罗恩病病因学中的作用。观察到的与肉类的关联以及与巴氏杀菌牛奶的负相关需要进一步研究。
