López-Serrano Pilar, Pérez-Calle José L, Pérez-Fernández Maria Teresa, Fernández-Font Juan Manuel, Boixeda de Miguel Daniel, Fernández-Rodríguez Conrado M
Department of Gastroenterology, Hospital Universitario Fundación Alcorcón, Spain.
Scand J Gastroenterol. 2010 Dec;45(12):1464-71. doi: 10.3109/00365521.2010.510575. Epub 2010 Aug 12.
Environmental factors have been implicated in the etiology of inflammatory bowel disease (IBD), but evidence for the hygiene hypothesis is unclear. We investigated the relationship between early-life infection-related exposures and risk of IBD.
A hospital-based case-control study was carried out. A total of 124 cases of Crohn's disease (CD) and 146 of ulcerative colitis (UC) were compared with 235 and 278 well-matched control subjects, respectively. A multi-item questionnaire on familial history of IBD, childhood circumstances and familial socioeconomic status was carried out.
In a multivariate model, living in urban areas (odds ratio (OR) 4.58 (95% CI 2.17-10)), high educational level (OR 1.83 (95% CI 14-2.95)) and social status (OR 1.68 (95% CI 1.2-2.35)) were risk factors for CD, whereas childhood respiratory infections (OR 0.35 (95% CI 0.23-0.52)) and gastroenteritis (OR 0.55 (95% CI 0.36-0.85)) were protective factors. Living in urban areas (OR 4.6 (95% CI 2.29-9.9)), a high educational level (OR 10.3 (95% CI 2.54-42.1)) and social status (OR 2.042 (95% CI 1.31-3.17)) were also risk factors for UC, whereas respiratory infections (OR 0.42 (95% CI 0.29-0.6)) and gastroenteritis (OR: 0.6 (95% CI 0.42-0.86)) were protective factors. Appendectomy (OR 0.173 (95% CI 0.06-0.52)) and current smoking (OR 0.75 (95% CI 0.59-0.96)) were also protective for UC.
These results further support the hypothesis that better living conditions during childhood are associated with an increased risk for IBD, and reinforce the negative association between smoking and appendectomy and the risk of UC.
环境因素被认为与炎症性肠病（IBD）的病因有关，但卫生假说的证据尚不清楚。我们调查了早期与感染相关的暴露因素与IBD风险之间的关系。
开展了一项基于医院的病例对照研究。分别将124例克罗恩病（CD）患者和146例溃疡性结肠炎（UC）患者与235例和278例匹配良好的对照者进行比较。进行了一项关于IBD家族史、童年情况和家族社会经济地位的多项目问卷调查。
在多变量模型中，居住在城市地区（比值比（OR）4.58（95%置信区间2.17 - 10））、高教育水平（OR 1.83（95%置信区间1.4 - 2.95））和社会地位（OR 1.68（95%置信区间1.2 - 2.35））是CD的危险因素，而儿童期呼吸道感染（OR 0.35（95%置信区间0.23 - 0.52））和肠胃炎（OR 0.55（95%置信区间0.36 - 0.85））是保护因素。居住在城市地区（OR 4.6（95%置信区间2.29 - 9.9））、高教育水平（OR 10.3（95%置信区间2.54 - 42.1））和社会地位（OR 2.042（95%置信区间1.31 - 3.17））也是UC的危险因素，而呼吸道感染（OR 0.42（95%置信区间0.29 - 0.6））和肠胃炎（OR：0.6（95%置信区间0.42 - 0.86））是保护因素。阑尾切除术（OR 0.173（95%置信区间0.06 - 0.52））和当前吸烟（OR 0.75（95%置信区间0.59 - 0.96））对UC也有保护作用。
这些结果进一步支持了童年时期更好的生活条件与IBD风险增加相关的假说，并强化了吸烟和阑尾切除术与UC风险之间的负相关关系。
