Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Dig Liver Dis. 2013 Jul;45(7):589-94. doi: 10.1016/j.dld.2013.01.028. Epub 2013 Mar 11.
Primary biliary cirrhosis is a cholestatic liver disease characterized by immune-mediated destruction of bile ducts. Its pathogenesis is largely unknown, although complex interactions between environment and genetic predisposition are proposed.
Identify disease risk factors using a detailed patient questionnaire and compare study findings to 3 published reports.
Questionnaire data were prospectively collected from 522 cases and 616 controls of the Mayo Clinic Primary Biliary Cirrhosis Genetic Epidemiology Registry. Case and control responses were compared using logistic regression, adjusting for recruitment age, sex, and education level.
Cases reported ever regularly smoking cigarettes more frequently than controls (P < 0.001). History of urinary tract infection was similar between groups; however, cases reported multiple urinary tract infections more commonly than controls (P < 0.001). Frequency of other autoimmune disease was higher in cases than controls (P < 0.001). As well, prevalence of primary biliary cirrhosis among first-degree relatives was higher in case families than control families (P < 0.001).
Our study confirms prior reported risk factors associated with disease risk. Given the potential importance of gene and environment interactions, further examination of environmental risk factors considering genetic background may provide new insight into primary biliary cirrhosis pathogenesis.
原发性胆汁性肝硬化是一种胆汁淤积性肝病，其特征为胆管的免疫介导性破坏。其发病机制在很大程度上尚不清楚，尽管提出了环境与遗传易感性之间的复杂相互作用。
使用详细的患者问卷确定疾病的危险因素，并将研究结果与 3 篇已发表的报告进行比较。
从 Mayo 诊所原发性胆汁性肝硬化遗传流行病学登记处的 522 例病例和 616 例对照前瞻性收集问卷数据。使用逻辑回归比较病例和对照的反应，调整招募年龄、性别和教育水平。
病例比对照更频繁地报告曾经定期吸烟（P < 0.001）。两组之间的尿路感染史相似；然而，病例比对照更常报告多次尿路感染（P < 0.001）。病例比对照更常报告其他自身免疫性疾病（P < 0.001）。此外，病例家族中一级亲属原发性胆汁性肝硬化的患病率高于对照家族（P < 0.001）。
我们的研究证实了先前报道的与疾病风险相关的危险因素。鉴于基因与环境相互作用的潜在重要性，进一步研究考虑遗传背景的环境危险因素可能为原发性胆汁性肝硬化的发病机制提供新的见解。
