Ye Kexin, Zhou Tianyu, Jin Zhenhe, Jiang Wenxi, Liu Zhaoxue, Shen Zhe
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, China.
BMC Gastroenterol. 2025 Sep 26;25(1):666. doi: 10.1186/s12876-025-04230-1.
Environmental factors play significant roles in the pathogenesis of inflammatory bowel disease. This study investigates the associations between hard water exposure and the prevalence and incidence of inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis.
A cross-sectional and cohort study was conducted using 481,468 participants in the UK Biobank. Logistic regression was used to examine associations between hard water exposure and disease prevalence at baseline, while Cox regression assessed associations with incident cases during follow-up.
A total of 481,468 participants were included in the cross-sectional study. Higher levels of hard water exposure were associated with reduced prevalence of Crohn’s disease (OR = 0.88, 95% CI: 0.79–0.99, = 0.027, and = 0.039 for the trend) and ulcerative colitis (OR = 0.83, 95% CI: 0.77–0.89, < 0.001, and < 0.001 for the trend). 475,895 participants with a mean follow-up of 14.6 years were included in the cohort study. Hard water was significantly associated with a decreased risk of Crohn’s disease (HR = 0.84, 95% CI: 0.73–0.97, = 0.016, and = 0.007 for the trend) but not ulcerative colitis. We also observed a stronger inverse association between very hard water and Crohn’s disease among individuals with low genetic risk. (HR = 0.74, 95% CI: 0.57–0.95, = 0.019).
Hard water is linked to a lower prevalence of both CD and UC, as well as a lower incidence of CD. However, no significant association was observed with the incidence of UC.
The online version contains supplementary material available at 10.1186/s12876-025-04230-1.
环境因素在炎症性肠病的发病机制中起着重要作用。本研究调查了接触硬水与炎症性肠病（包括克罗恩病和溃疡性结肠炎）的患病率和发病率之间的关联。
利用英国生物银行中的481468名参与者进行了一项横断面和队列研究。采用逻辑回归分析基线时接触硬水与疾病患病率之间的关联，而采用Cox回归评估随访期间与发病病例的关联。
横断面研究共纳入481468名参与者。较高水平的硬水接触与克罗恩病患病率降低相关（比值比[OR]=0.88，95%置信区间[CI]：0.79-0.99，P=0.027，趋势P=0.039）以及溃疡性结肠炎患病率降低相关（OR=0.83，95%CI：0.77-0.89，P<0.001，趋势P<0.001）。队列研究纳入了475895名平均随访14.6年的参与者。硬水与克罗恩病风险降低显著相关（风险比[HR]=0.84，95%CI：0.73-0.97，P=0.016，趋势P=0.007），但与溃疡性结肠炎无关。我们还观察到在遗传风险较低的个体中，极硬水与克罗恩病之间存在更强的负相关（HR=0.74，95%CI：0.57-0.95，P=0.019）。
硬水与克罗恩病和溃疡性结肠炎的较低患病率以及克罗恩病的较低发病率相关。然而，未观察到与溃疡性结肠炎发病率的显著关联。
在线版本包含可在10.1186/s12876-025-04230-1获取的补充材料。
