Burisch J, Pedersen N, Cukovic-Cavka S, Turk N, Kaimakliotis I, Duricova D, Bortlik M, Shonová O, Vind I, Avnstrøm S, Thorsgaard N, Krabbe S, Andersen V, Dahlerup J F, Kjeldsen J, Salupere R, Olsen J, Nielsen K R, Manninen P, Collin P, Katsanos K H, Tsianos E V, Ladefoged K, Lakatos L, Ragnarsson G, Björnsson E, Bailey Y, O'Morain C, Schwartz D, Odes S, Giannotta M, Girardin G, Kiudelis G, Kupcinskas L, Turcan S, Barros L, Magro F, Lazar D, Goldis A, Nikulina I, Belousova E, Martinez-Ares D, Hernandez V, Almer S, Zhulina Y, Halfvarson J, Arebi N, Tsai H H, Sebastian S, Lakatos P L, Langholz E, Munkholm P
Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
Digestive Disease Centre, Medical Section, Herlev University Hospital, Copenhagen, Denmark.
J Crohns Colitis. 2014 Jul;8(7):607-16. doi: 10.1016/j.crohns.2013.11.021. Epub 2013 Dec 7.
The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe possibly due to changes in environmental factors towards a more "westernised" standard of living. The aim of this study was to investigate differences in exposure to environmental factors prior to diagnosis in Eastern and Western European IBD patients.
The EpiCom cohort is a population-based, prospective inception cohort of 1560 unselected IBD patients from 31 European countries covering a background population of 10.1 million. At the time of diagnosis patients were asked to complete an 87-item questionnaire concerning environmental factors.
A total of 1182 patients (76%) answered the questionnaire, 444 (38%) had Crohn's disease (CD), 627 (53%) ulcerative colitis (UC), and 111 (9%) IBD unclassified. No geographic differences regarding smoking status, caffeine intake, use of oral contraceptives, or number of first-degree relatives with IBD were found. Sugar intake was higher in CD and UC patients from Eastern Europe than in Western Europe while fibre intake was lower (p<0.01). Daily consumption of fast food as well as appendectomy before the age of 20 was more frequent in Eastern European than in Western European UC patients (p<0.01). Eastern European CD and UC patients had received more vaccinations and experienced fewer childhood infections than Western European patients (p<0.01).
In this European population-based inception cohort of unselected IBD patients, Eastern and Western European patients differed in environmental factors prior to diagnosis. Eastern European patients exhibited higher occurrences of suspected risk factors for IBD included in the Western lifestyle.
东欧炎症性肠病（IBD）的发病率正在上升，这可能是由于环境因素朝着更“西化”的生活水平转变所致。本研究的目的是调查东欧和西欧IBD患者在诊断前接触环境因素的差异。
EpiCom队列是一项基于人群的前瞻性起始队列研究，纳入了来自31个欧洲国家的1560例未经选择的IBD患者，背景人群达1010万。在诊断时，要求患者完成一份关于环境因素的87项问卷。
共有1182例患者（76%）回答了问卷，其中444例（38%）患有克罗恩病（CD），627例（53%）患有溃疡性结肠炎（UC），111例（9%）为未分类的IBD。在吸烟状况、咖啡因摄入量、口服避孕药的使用或患有IBD的一级亲属数量方面未发现地理差异。东欧CD和UC患者的糖摄入量高于西欧，而纤维摄入量较低（p<0.01）。东欧UC患者每日食用快餐以及20岁前接受阑尾切除术的频率高于西欧患者（p<0.01）。东欧CD和UC患者接种的疫苗更多，儿童期感染经历比西欧患者少（p<0.01）。
在这个基于欧洲人群的未经选择的IBD患者起始队列中，东欧和西欧患者在诊断前的环境因素存在差异。东欧患者表现出更多西方生活方式中包含的IBD疑似危险因素。
