Fantodji Canisius, Rousseau Marie-Claude, Nicolau Belinda, Madathil Sreenath, Benedetti Andrea, Jantchou Prévost
Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique (INRS), Laval, Qc, H7V 1B7, Canada; Research Centre, Sainte-Justine University Hospital Centre (CHU Sainte-Justine), Montréal, Qc, Canada; Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics CHU Sainte-Justine, Montréal, Qc, Canada.
Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique (INRS), Laval, Qc, H7V 1B7, Canada; School of Public Health, Université de Montréal, Montréal, Qc, Canada; Innovation Hub, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Qc, Canada.
Dig Liver Dis. 2025 Jan;57(1):290-297. doi: 10.1016/j.dld.2024.09.011. Epub 2024 Oct 8.
Early life factors for inflammatory bowel disease are likely to impact the gut microbiota.
We investigated the associations between early exposures and inflammatory bowel disease.
This case-control study was nested within the CO·MMUNITY cohort. Cases of Crohn's disease (CD) and ulcerative colitis (UC) were identified using validated algorithms. All cases and randomly selected controls were invited to complete a questionnaire including early life exposures. Analyses were conducted by logistic regression and causal mediation (direct/indirect effects for passive/active smoking).
Early introduction of solid foods at 3-6 months tended to increase CD risk compared to later introduction (>6 months): OR = 1.23; 95 % CI: 0.96-1.56, but not of UC. Exclusive breastfeeding tended to decrease the risk of CD (OR = 0.77; 95 % CI: 0.55-1.08), less so for UC. Antibiotics tended to decrease CD (OR = 0.89; 95 % CI: 0.74-1.07) and UC (OR = 0.88; 95 % CI: 0.71-1.09). No association was found between pets and CD or UC. Passive smoking increased CD risk (OR = 1.23; 95 % CI: 1.00-1.51), 20 % of which was mediated by active smoking, but not UC.
Differences were noticed in early risk factors for CD and UC. The impact of passive smoking was largely independent of active smoking, highlighting its importance for prevention.
炎症性肠病的早期生活因素可能会影响肠道微生物群。
我们调查了早期暴露与炎症性肠病之间的关联。
本病例对照研究嵌套于CO·MMUNITY队列中。使用经过验证的算法确定克罗恩病（CD）和溃疡性结肠炎（UC）病例。邀请所有病例和随机选择的对照完成一份包括早期生活暴露情况的问卷。通过逻辑回归和因果中介分析（被动/主动吸烟的直接/间接影响）。
与较晚引入固体食物（>6个月）相比，在3至6个月时过早引入固体食物往往会增加患CD的风险：比值比（OR）=1.23；95%置信区间（CI）：0.96 - 1.56，但对UC无此影响。纯母乳喂养往往会降低患CD的风险（OR = 0.77；95% CI：0.55 - 1.08），对UC的降低作用较小。抗生素往往会降低CD（OR = 0.89；95% CI：0.74 - 1.07）和UC（OR = 0.88；95% CI：0.71 - 1.09）的风险。未发现宠物与CD或UC之间存在关联。被动吸烟会增加CD风险（OR = 1.23；95% CI：1.00 - 1.51），其中20%由主动吸烟介导，但对UC无此影响。
注意到CD和UC的早期风险因素存在差异。被动吸烟的影响在很大程度上独立于主动吸烟，突出了其在预防方面的重要性。
