Early life environment and natural history of inflammatory bowel diseases View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-12-16

AUTHORS

Abra Y Guo, Betsy W Stevens, Robin G Wilson, Caitlin N Russell, Melissa A Cohen, Holly C Sturgeon, Anna Thornton, Cosmas Giallourakis, Hamed Khalili, Deanna D Nguyen, Jenny Sauk, Vijay Yajnik, Ramnik J Xavier, Ashwin N Ananthakrishnan

ABSTRACT

BackgroundEarly life exposures may modify risk of inflammatory bowel diseases (IBD; Crohn’s disease (CD), ulcerative colitis (UC)). However, the relationship between early life exposures and natural history of IBD has not been previously examined.MethodsThis single center study included patients with CD or UC recruited in a prospective IBD registry. Enrolled patients completed a detailed environmental questionnaire that assessed various early life environmental exposures. Our primary outcome was requirement for disease-related surgery in CD and UC. Logistic regression models defined independent effect of early life exposures, adjusting for potential confounders.ResultsOur study included 333 CD and 270 UC patients. Just over half were female with a median age at diagnosis of 25 years. One-third of the cohort had history of bowel surgery (31%) and nearly half had used at least one biologic agent (47%). Among those with CD, being breastfed was associated with reduced risk of CD-related surgery (34% vs. 55%), while childhood cigarette smoke exposure was associated with increased risk. On multivariate analysis, history of being breastfed (odds ratio (OR) 0.21, 95% confidence interval [CI] 0.09–0.46) and cigarette smoke exposure as a child (OR 2.17, 95% CI 1.10–4.29) remained independently associated with surgery. None of the early life variables influenced disease phenotype or outcome in UC.ConclusionA history of being breastfed was associated with a decreased risk while childhood cigarette smoke exposure was associated with an increased risk of surgery in patients with CD. Further investigation to examine biological mechanisms is warranted. More... »

PAGES

216

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12876-014-0216-8

DOI

http://dx.doi.org/10.1186/s12876-014-0216-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052669684

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25510175


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53 disease phenotype
54 disease-related surgery
55 early life environment
56 early life environmental exposures
57 early life exposure
58 early life variables
59 effect
60 environment
61 environmental exposures
62 environmental questionnaire
63 exposure
64 further investigation
65 half
66 history
67 independent effects
68 inflammatory bowel disease
69 investigation
70 life environment
71 life exposure
72 life variables
73 logistic regression models
74 mechanism
75 median age
76 model
77 multivariate analysis
78 natural history
79 one-third
80 outcomes
81 patients
82 phenotype
83 potential confounders
84 primary outcome
85 questionnaire
86 registry
87 regression models
88 relationship
89 requirements
90 risk
91 risk of surgery
92 single-center study
93 smoke exposure
94 study
95 surgery
96 variables
97 years
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