Mendall Michael, Jensen Camilla B, Ängquist Lars H, Baker Jennifer L, Jess Tine
Department of Gastroenterology, Croydon University Hospital, Thornton Heath , Surrey , UK.
Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region , Copenhagen , Denmark.
Scand J Gastroenterol. 2019 Jul;54(7):863-868. doi: 10.1080/00365521.2019.1635201. Epub 2019 Jul 11.
Growth in childhood is associated with later development of autoimmune diseases and cancer, but the impact of growth on risk of inflammatory bowel disease (IBD) remains unknown. We conducted a population-based cohort study to examine whether birth weight, childhood height, or changes in height associated with later risk of IBD. Our cohort consisted of 317,030 children from the Copenhagen School Health Records Register (born 1930-1989) with height repeatedly measured from age 7 to 13 and with data on birth weight on a subset. Through linkage to the Danish National Patients Register, cases of IBD were identified. Cox proportional hazard regression was used to examine associations between measures of childhood growth and risk of IBD. During more than 9 million years of follow-up, 1612 individuals were diagnosed with Crohn's disease (CD) and 2,640 with ulcerative colitis (UC). Birth weight and childhood heights were not associated with subsequent risk of CD or UC (HRs close to 1.00). Childhood growth from 7 to 10 years (CD: HR, 1.00; 95% CI, 0.85-1.18; UC: HR, 0.92; 95% CI, 0.81-1.05) and 10 to 13 years (CD: HR, 1.02; 95% CI, 0.89-1.17; UC: HR, 0.95; 0.85-1.05) did not associate with risk of IBD either. In this large population-based cohort study, birth weight and childhood growth did not influence risk of IBD, which contrasts with observations in other chronic diseases. Thereby, the study also suggests that pre-clinical effects of adult IBD are not measurable in childhood and that childhood risk factors for IBD do not influence growth.
儿童期生长与自身免疫性疾病和癌症的后期发展相关，但生长对炎症性肠病（IBD）风险的影响尚不清楚。我们进行了一项基于人群的队列研究，以检查出生体重、儿童期身高或身高变化是否与IBD的后期风险相关。我们的队列包括来自哥本哈根学校健康记录登记处的317,030名儿童（出生于1930年至1989年），他们从7岁到13岁期间多次测量身高，并且部分儿童有出生体重数据。通过与丹麦国家患者登记处的关联，确定了IBD病例。使用Cox比例风险回归来检查儿童期生长指标与IBD风险之间的关联。在超过900万年的随访期间，1612人被诊断为克罗恩病（CD），2640人被诊断为溃疡性结肠炎（UC）。出生体重和儿童期身高与CD或UC的后续风险无关（风险比接近1.00）。7至10岁（CD：风险比，1.00；95%置信区间，0.85 - 1.18；UC：风险比，0.92；95%置信区间，0.81 - 1.05）和10至13岁（CD：风险比，1.02；95%置信区间，0.89 - 1.17；UC：风险比，0.95；0.85 - 1.05）的儿童期生长也与IBD风险无关。在这项基于人群的大型队列研究中，出生体重和儿童期生长并未影响IBD风险，这与其他慢性疾病的观察结果形成对比。因此，该研究还表明，成人IBD的临床前效应在儿童期无法测量，并且IBD的儿童期风险因素不会影响生长。
