Gastrointestinal Unit, Medical Section, Herlev University Hospital, Statens Serum Institut, Copenhagen, Denmark.
J Crohns Colitis. 2011 Dec;5(6):577-84. doi: 10.1016/j.crohns.2011.05.010. Epub 2011 Jun 28.
The role of environmental factors in development of inflammatory bowel disease (IBD) remains uncertain. The aim of the present study was to assess a number of formerly suggested environmental factors in a case-control study of an unselected and recently diagnosed group of patients with IBD and a control group of orthopaedic patients.
A total of 123 patients diagnosed with Crohn's disease (CD) and 144 with ulcerative colitis (UC) in Copenhagen (2003-2004) were matched 1:1 on age and gender to 267 orthopaedic controls. Participants received a questionnaire with 87 questions concerning environmental factors prior to IBD/orthopaedic admission. Odds ratios (OR) were calculated by logistic regression.
Being breastfed >6 months (OR, 0.50; 95% CI, 0.23-1.11) and undergoing tonsillectomy (OR, 0.49; 95% CI, 0.31-0.78) decreased the odds for IBD, whereas appendectomy decreased the odds for UC only (OR, 0.29; 95% CI, 0.12-0.71). Vaccination against pertussis (OR, 2.08; 95% CI, 1.07-4.03) and polio (OR, 2.38; 95% CI, 1.04-5.43) increased the odds for IBD, whereas measles infection increased the odds for UC (OR, 3.50; 95% CI, 1.15-10.6). Low consumption of fibres and high consumption of sugar were significantly associated with development of CD and UC. Smoking increased the risk for CD and protected against UC.
Among Danish patients with CD and UC belonging to an unselected cohort, disease occurrence was found to be associated both with well-known factors such as smoking and appendectomy, and with more debated factors including breastfeeding, tonsillectomy, childhood vaccinations, childhood infections, and dietary intake of fibres and sugar.
环境因素在炎症性肠病（IBD）发展中的作用仍不确定。本研究的目的是在一项对未经选择且最近诊断为 IBD 的患者组和骨科患者对照组进行的病例对照研究中评估一些先前提出的环境因素。
2003-2004 年在哥本哈根，共诊断出 123 例克罗恩病（CD）和 144 例溃疡性结肠炎（UC）患者，按照年龄和性别与 267 例骨科对照 1:1 匹配。在 IBD/骨科入院前，参与者接受了一份包含 87 个环境因素问题的问卷。通过逻辑回归计算比值比（OR）。
母乳喂养>6 个月（OR，0.50；95%CI，0.23-1.11）和扁桃体切除术（OR，0.49；95%CI，0.31-0.78）降低了 IBD 的几率，而阑尾切除术仅降低了 UC 的几率（OR，0.29；95%CI，0.12-0.71）。百白破（OR，2.08；95%CI，1.07-4.03）和脊髓灰质炎（OR，2.38；95%CI，1.04-5.43）疫苗接种增加了 IBD 的几率，而麻疹感染增加了 UC 的几率（OR，3.50；95%CI，1.15-10.6）。低纤维摄入量和高糖摄入量与 CD 和 UC 的发生显著相关。吸烟增加了 CD 的风险，同时降低了 UC 的风险。
在丹麦未选择的 CD 和 UC 患者队列中，疾病发生与吸烟和阑尾切除术等已知因素以及母乳喂养、扁桃体切除术、儿童疫苗接种、儿童感染和纤维和糖的饮食摄入量等更具争议的因素均有关联。
