Jiang Li, Xia Bing, Li Jin, Ye Mei, Deng Changsheng, Ding Yijuan, Luo Hesheng, Ren Hongyu, Hou Xiaohua, Liu Hongying, Xu Hualin, Cheng Hong, Yang Huiying
Department of Internal Medicine and Geriatrics of Zhongnan Hospital, Wuhan University School of Medicine, Wuhan, PR China.
J Clin Gastroenterol. 2007 Mar;41(3):280-4. doi: 10.1097/01.mcg.0000225644.75651.f1.
Cigarette smoking, alcohol use, appendectomy, and family history of inflammatory bowel disease (IBD) have all been shown to be associated with IBD, but there were no reports of risk factors for IBD in a Chinese population in which the incidence of IBD is increasing during the past decade. We conducted a case-control study to examine associations between previously reported environmental risk factors and development of ulcerative colitis (UC) in Wuhan city, central China.
A total of 177 patients with UC and 177 age-matched and sex-matched controls were prospectively studied in Wuhan city from January 2004 to December 2004. An age-matched and sex-matched case-control study was conducted to assess the role of smoking, alcohol use, appendectomy, and other potential risk factors in the development of UC by a detailed questionnaire.
Smoking was a protective factor and exsmoking is a risk factor for UC [compared with nonsmokers, smokers: odds ratios (OR)=0.28, 95% confidence intervals (CI): 0.16-0.48, P=0.0001; exsmokers: OR=4.36, 95%CI: 1.46-13.04, P=0.008]. Positive family history of IBD was a risk factor (OR=4.35, 95%CI: 1.21-15.71, P=0.025) whereas appendectomy was a protective factor (OR=0.24, 95%CI: 0.07-0.86, P=0.028) for UC. There were no significant associations between UC and other factors examined.
Although the incidence of UC in Chinese is relatively lower than that in white, the same risk factors for UC that were reported in white populations were associated with Chinese UC patients. Specifically, smoking was a protective factor for UC and exsmoking was associated with an increase risk of UC in a Chinese population. Family history of IBD was shown to be a risk for UC, whereas appendectomy was associated with a low risk for UC.
吸烟、饮酒、阑尾切除术以及炎性肠病（IBD）家族史均已被证明与IBD相关，但在中国人群中，过去十年IBD发病率呈上升趋势，此前尚无关于IBD危险因素的报道。我们开展了一项病例对照研究，以探讨中国中部武汉市既往报道的环境危险因素与溃疡性结肠炎（UC）发病之间的关联。
2004年1月至2004年12月期间，在武汉市对177例UC患者及177例年龄和性别匹配的对照进行了前瞻性研究。通过详细问卷进行年龄和性别匹配的病例对照研究，以评估吸烟、饮酒、阑尾切除术及其他潜在危险因素在UC发病中的作用。
吸烟是UC的保护因素，戒烟是UC的危险因素[与不吸烟者相比，吸烟者：比值比（OR）=0.28，95%置信区间（CI）：0.16 - 0.48，P =0.0001；戒烟者：OR =4.36，95%CI：1.46 - 13.04，P =0.008]。IBD家族史阳性是危险因素（OR =4.35），95%CI：1.21 - 15.71，P =0.025），而阑尾切除术是UC的保护因素（OR =0.24，95%CI：0.07 - 0.86，P =0.028）。UC与其他所研究因素之间无显著关联。
尽管中国UC的发病率相对低于白人，但白人人群中报道的相同UC危险因素与中国UC患者相关。具体而言，吸烟是中国人群中UC的保护因素，戒烟与UC风险增加相关。IBD家族史被证明是UC的危险因素，而阑尾切除术与UC低风险相关。
