Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Am J Gastroenterol. 2010 Nov;105(11):2412-9. doi: 10.1038/ajg.2010.252. Epub 2010 Jun 29.
The inflammatory bowel diseases (IBDs) emerged after industrialization. We studied whether ambient air pollution levels were associated with the incidence of IBD.
The health improvement network (THIN) database in the United Kingdom was used to identify incident cases of Crohn's disease (n=367) or ulcerative colitis (n=591), and age- and sex-matched controls. Conditional logistic regression analyses assessed whether IBD patients were more likely to live in areas of higher ambient concentrations of nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), and particulate matter <10 μm (PM(10)), as determined by using quintiles of concentrations, after adjusting for smoking, socioeconomic status, non-steroidal anti-inflammatory drugs (NSAIDs), and appendectomy. Stratified analyses investigated effects by age.
Overall, NO(2), SO(2), and PM(10) were not associated with the risk of IBD. However, individuals ≤23 years were more likely to be diagnosed with Crohn's disease if they lived in regions with NO(2) concentrations within the upper three quintiles (odds ratio (OR)=2.31; 95% confidence interval (CI)=1.25-4.28), after adjusting for confounders. Among these Crohn's disease patients, the adjusted OR increased linearly across quintile levels for NO(2) (P=0.02). Crohn's disease patients aged 44-57 years were less likely to live in regions of higher NO(2) (OR=0.56; 95% CI=0.33-0.95) and PM(10) (OR=0.48; 95% CI=0.29-0.80). Ulcerative colitis patients ≤25 years (OR=2.00; 95% CI=1.08-3.72) were more likely to live in regions of higher SO(2); however, a dose-response effect was not observed.
On the whole, air pollution exposure was not associated with the incidence of IBD. However, residential exposures to SO(2) and NO(2) may increase the risk of early-onset ulcerative colitis and Crohn's disease, respectively. Future studies are needed to explore the age-specific effects of air pollution exposure on IBD risk.
炎症性肠病（IBD）是在工业化之后出现的。本研究旨在探讨环境空气污染水平是否与 IBD 的发病有关。
本研究使用英国健康改善网络（THIN）数据库，以确定克罗恩病（n=367）或溃疡性结肠炎（n=591）的发病病例，并以年龄和性别匹配的对照。采用条件逻辑回归分析，在调整吸烟、社会经济地位、非甾体类抗炎药（NSAIDs）和阑尾切除术等因素后，评估 IBD 患者是否更有可能居住在二氧化氮（NO2）、二氧化硫（SO2）和<10μm 颗粒物（PM10）浓度较高的地区，这些地区是通过浓度的五分位数来确定的。分层分析探讨了年龄的影响。
总体而言，NO2、SO2 和 PM10 与 IBD 的发病风险无关。然而，≤23 岁的个体如果居住在 NO2 浓度在前三个五分位数的地区，更有可能被诊断为克罗恩病（优势比（OR）=2.31；95%置信区间（CI）=1.25-4.28），在调整混杂因素后。在这些克罗恩病患者中，NO2 五分位水平的调整 OR 呈线性增加（P=0.02）。44-57 岁的克罗恩病患者不太可能居住在较高的 NO2（OR=0.56；95%CI=0.33-0.95）和 PM10（OR=0.48；95%CI=0.29-0.80）地区。≤25 岁的溃疡性结肠炎患者（OR=2.00；95%CI=1.08-3.72）更有可能居住在较高的 SO2 地区；然而，未观察到剂量-反应效应。
总的来说，空气污染暴露与 IBD 的发病无关。然而，SO2 和 NO2 的住宅暴露可能分别增加早发性溃疡性结肠炎和克罗恩病的风险。需要进一步的研究来探索空气污染暴露对 IBD 风险的年龄特异性影响。
