吸烟和饮酒习惯与显微镜下结肠炎女性患者的临床表现与对照组的关系。
Smoking- and alcohol habits in relation to the clinical picture of women with microscopic colitis compared to controls.
机构信息
Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
出版信息
BMC Womens Health. 2014 Jan 23;14:16. doi: 10.1186/1472-6874-14-16.
BACKGROUND
Microscopic colitis (MC) induces gastrointestinal symptoms, which are partly overlapping with irritable bowel syndrome (IBS), predominately in middle-aged and elderly women. The etiology is unknown, but association with smoking has been found. The aim of this study was to examine whether the increased risk for smokers to develop MC is a true association, or rather the result of confounding factors. Therefore, patients suffering from MC and population-based controls from the same geographic area were studied regarding smoking- and alcohol habits, and other simultaneous, lifestyle factors, concerning the clinical expression of the disease.
METHODS
Women at the age of 73 years or younger, who had been treated for biopsy-verified MC at any of the Departments of Gastroenterology in Skåne, between 2002 and 2010, were invited to the study (240 patients). Women (737) from the population-based prospective cohort study, Malmö Diet and Cancer Study (MDCS), served as controls. A self-administered questionnaire about lifestyle factors, gastrointestinal symptoms, medical conditions and medication at the time for the study was sent by post.
RESULTS
Altogether, 131 women with MC could be included after age-matching with controls (median age 56 years) and exclusion of secondary MC. Patients were divided into persistent MC (MC1) and transient MC (MC2). Past smoking was associated with increased risk to develop MC2 (OR = 2.67, 95 CI = 1.15-6.23), whereas current smoking was associated with increased risk to develop MC1 (OR = 3.18, 95 CI = 1.57-6.42). Concomitant symptoms of IBS were associated with smoking (OR = 4.24, 95 CI = 1.92-9.32). Alcohol drinking had no association with MC or IBS.
CONCLUSIONS
The results suggest that past smoking is associated with transient MC, whereas current smoking is associated with persistent MC. Smoking is associated with MC patients with concomitant IBS-like symptoms.
背景
显微镜下结肠炎（MC）会引起胃肠道症状，这些症状与肠易激综合征（IBS）部分重叠，主要发生在中年和老年女性中。其病因尚不清楚，但已发现与吸烟有关。本研究旨在探讨吸烟者患 MC 的风险增加是真实关联，还是混杂因素的结果。因此，研究人员对在斯堪的纳维亚的胃肠病学系接受活检证实为 MC 治疗的患者（240 例患者）和来自同一地理区域的基于人群的对照者进行了吸烟和饮酒习惯以及其他同时存在的生活方式因素的研究，这些因素与疾病的临床表现有关。
方法
2002 年至 2010 年间，在斯堪的纳维亚的任何一个胃肠病学系接受活检证实为 MC 治疗的年龄在 73 岁或以下的女性（240 例患者）被邀请参加本研究。来自基于人群的前瞻性队列研究马尔默饮食与癌症研究（MDCS）的女性（737 名）作为对照。在研究时，通过邮寄方式向她们发送了一份关于生活方式因素、胃肠道症状、疾病状况和用药情况的自我管理问卷。
结果
经过与对照组（中位年龄 56 岁）进行年龄匹配并排除继发性 MC 后，共有 131 名 MC 患者可纳入本研究。患者被分为持续 MC（MC1）和短暂 MC（MC2）。过去吸烟与发生 MC2 的风险增加相关（OR=2.67，95%CI=1.15-6.23），而当前吸烟与发生 MC1 的风险增加相关（OR=3.18，95%CI=1.57-6.42）。同时伴有 IBS 症状与吸烟有关（OR=4.24，95%CI=1.92-9.32）。饮酒与 MC 或 IBS 无关。
结论
结果表明，过去吸烟与短暂 MC 有关，而当前吸烟与持续 MC 有关。吸烟与同时伴有 IBS 样症状的 MC 患者有关。
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