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Erschienen in: Indian Journal of Gastroenterology 3/2018

09.07.2018 | Original Article

Risk factors for inflammatory bowel disease: A prospective multi-center study

verfasst von: Anjali D. Amarapurkar, Deepak N. Amarapurkar, Pravin Rathi, Prabha Sawant, Nikhil Patel, Praful Kamani, Krishnakant Rawal, Rajiv Baijal, Ameya Sonawane, Nitin Narawane, Samrat Kolekar, Naveen Totla

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 3/2018

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Abstract

Introduction

Environmental risk factors have been associated with inflammatory bowel disease (IBD). With rising incidence, it is important to know risk factors associated with IBD in our population. This study was aimed to evaluate risk factors for IBD from western India.

Methods

This was prospective, multi-center case-control study which included 1054 patients with IBD of which 765 (72.5%) were ulcerative colitis (UC) and 289 (27.4%) Crohn’s disease (CD). Asymptomatic individuals without a history of any major illness served as controls. The questionnaire containing risk factors for IBD was given to patients and control group. Odds ratio and 95% confidence interval were calculated for each variable.

Result

Significant numbers of patients with CD were from rural area. Rural environment (OR 1.071, 0.82–1.38 and OR 1.441, 1.02–2.02), higher education (OR 1.830, 1.52–2.19 and OR 1.519, 1.16–1.97), professional by occupation (OR 1.754, 1.46–2.09 and OR 1.293, 0.99–1.67), annual family income >100,000 Indian national rupees (OR 2.185, 1.52–3.13 and OR 4.648, 3.10–6.95), history of appendectomy (OR 3.158, 1.71–5.80 and OR 3.158, 1.71–5.80), and family history of IBD (OR 4.510, 2.19–9.25 and OR 3.972, 1.58–9.96) were the risk factors for UC and CD, respectively. Vegetarian diet was protective factor for UC (OR 0.29, 0.27–0.39) and risk for CD (OR 1.179, 0.88–1.57). Smoking and chronic alcoholism were not found to be the risk factors.

Conclusion

This study highlights association between socioeconomic, dietary factors, appendectomy, and family history as risk factors for IBD.
Literatur
1.
Zurück zum Zitat M’Koma AE. Inflammatory bowel disease: an expanding global health problem. Clin Med Insights Gastroenterol. 2013;6:33–47.PubMedPubMedCentral M’Koma AE. Inflammatory bowel disease: an expanding global health problem. Clin Med Insights Gastroenterol. 2013;6:33–47.PubMedPubMedCentral
2.
Zurück zum Zitat Ananthakrishnan AN. Epidemiology and risk factors for inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2015;12:205–17.CrossRefPubMed Ananthakrishnan AN. Epidemiology and risk factors for inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2015;12:205–17.CrossRefPubMed
3.
Zurück zum Zitat Ponder A, Long MD. A clinical review of recent findings in the epidemiology of inflammatory bowel diseases. Clin Epidemiol. 2013;5:237–47.PubMedPubMedCentral Ponder A, Long MD. A clinical review of recent findings in the epidemiology of inflammatory bowel diseases. Clin Epidemiol. 2013;5:237–47.PubMedPubMedCentral
4.
Zurück zum Zitat Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142:46–54.e42. Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142:46–54.e42.
5.
Zurück zum Zitat Yang Y, Owyang C, Wu GD. East meets West: the increasing incidence of inflammatory bowel disease in Asia as a paradigm for environmental effects on the pathogenesis of immune-mediated disease. Gastroenterology. 2016;151:e1–e5.CrossRefPubMedPubMedCentral Yang Y, Owyang C, Wu GD. East meets West: the increasing incidence of inflammatory bowel disease in Asia as a paradigm for environmental effects on the pathogenesis of immune-mediated disease. Gastroenterology. 2016;151:e1–e5.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Ng SC, Tang W, Ching JY, et al. Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn’s and colitis epidemiology study. Gastroenterology. 2013;145:158–165.e2.CrossRefPubMed Ng SC, Tang W, Ching JY, et al. Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn’s and colitis epidemiology study. Gastroenterology. 2013;145:158–165.e2.CrossRefPubMed
9.
Zurück zum Zitat Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Asian ethnic origin and the risk of inflammatory bowel disease. Eur J Gastroenterol Hepatol. 1999;11:543–6.CrossRefPubMed Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Asian ethnic origin and the risk of inflammatory bowel disease. Eur J Gastroenterol Hepatol. 1999;11:543–6.CrossRefPubMed
10.
Zurück zum Zitat Bernstein CN, Shanahan F. Disorders of a modern lifestyle: reconciling the epidemiology of inflammatory bowel diseases. Gut. 2008;57:1185–91.CrossRefPubMed Bernstein CN, Shanahan F. Disorders of a modern lifestyle: reconciling the epidemiology of inflammatory bowel diseases. Gut. 2008;57:1185–91.CrossRefPubMed
11.
Zurück zum Zitat Khosla SN, Girdhar NK, Lal S, Mishra DS. Epidemiology of ulcerative colitis in hospital and select general population of northern India. J Assoc Physicians India. 1986;34:405–7.PubMed Khosla SN, Girdhar NK, Lal S, Mishra DS. Epidemiology of ulcerative colitis in hospital and select general population of northern India. J Assoc Physicians India. 1986;34:405–7.PubMed
12.
13.
Zurück zum Zitat Das K, Ghoshal UC, Dhali GK, Benjamin J, Ahuja V, Makharia GK. Crohn’s disease in India: a multicenter study from a country where tuberculosis is endemic. Dig Dis Sci. 2009;54:1099–107.CrossRefPubMed Das K, Ghoshal UC, Dhali GK, Benjamin J, Ahuja V, Makharia GK. Crohn’s disease in India: a multicenter study from a country where tuberculosis is endemic. Dig Dis Sci. 2009;54:1099–107.CrossRefPubMed
14.
Zurück zum Zitat Amarapurkar DN, Patel ND, Rane PS. Diagnosis of Crohn’s disease in India where tuberculosis is widely prevalent. World J Gastroenterol. 2008;14:741–6. Amarapurkar DN, Patel ND, Rane PS. Diagnosis of Crohn’s disease in India where tuberculosis is widely prevalent. World J Gastroenterol. 2008;14:741–6.
15.
Zurück zum Zitat Cleynen I, Boucher G, Jostins L, et al. Inherited determinants of Crohn’s disease and ulcerative colitis phenotypes: a genetic association study. Lancet. 2016;387:156–67.CrossRefPubMedPubMedCentral Cleynen I, Boucher G, Jostins L, et al. Inherited determinants of Crohn’s disease and ulcerative colitis phenotypes: a genetic association study. Lancet. 2016;387:156–67.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Pugazhendhi S, Sahu MK, Subramanian V, Pulimood A, Ramakrishna BS. Environmental factors associated with Crohn’s disease in India. Indian J Gastroenterol. 2011;30:264–9.CrossRefPubMed Pugazhendhi S, Sahu MK, Subramanian V, Pulimood A, Ramakrishna BS. Environmental factors associated with Crohn’s disease in India. Indian J Gastroenterol. 2011;30:264–9.CrossRefPubMed
17.
Zurück zum Zitat Sood A, Amre D, Midha V, A, et al. Low hygiene and exposure to infections may be associated with increased risk for ulcerative colitis in a North Indian population. Ann Gastroenterol. 2014;27:219–23. Sood A, Amre D, Midha V, A, et al. Low hygiene and exposure to infections may be associated with increased risk for ulcerative colitis in a North Indian population. Ann Gastroenterol. 2014;27:219–23.
18.
Zurück zum Zitat Makharia GK, Ramakrishna BS, Abraham P, et al. Survey of inflammatory bowel diseases in India. Indian J Gastroenterol. 2012;31:299–306.CrossRefPubMed Makharia GK, Ramakrishna BS, Abraham P, et al. Survey of inflammatory bowel diseases in India. Indian J Gastroenterol. 2012;31:299–306.CrossRefPubMed
19.
Zurück zum Zitat Soon IS, Molodecky NA, Rabi DM, Ghali WA, Barkema HW, Kaplan GG. The relationship between urban environment and the inflammatory bowel diseases: a systematic review and meta-analysis. BMC Gastroenterol. 2012;12:51.CrossRefPubMedPubMedCentral Soon IS, Molodecky NA, Rabi DM, Ghali WA, Barkema HW, Kaplan GG. The relationship between urban environment and the inflammatory bowel diseases: a systematic review and meta-analysis. BMC Gastroenterol. 2012;12:51.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Maté-Jimenez J, Muñoz S, Vicent D, Pajares JM. Incidence and prevalence of ulcerative colitis and Crohn’s disease in urban and rural areas of Spain from 1981 to 1988. J Clin Gastroenterol. 1994;18:27–31.CrossRefPubMed Maté-Jimenez J, Muñoz S, Vicent D, Pajares JM. Incidence and prevalence of ulcerative colitis and Crohn’s disease in urban and rural areas of Spain from 1981 to 1988. J Clin Gastroenterol. 1994;18:27–31.CrossRefPubMed
21.
Zurück zum Zitat Wang YF, Ou-Yang Q, Xia B, et al. Multicenter case-control study of the risk factors for ulcerative colitis in China. World J Gastroenterol. 2013;19:1827–33. Wang YF, Ou-Yang Q, Xia B, et al. Multicenter case-control study of the risk factors for ulcerative colitis in China. World J Gastroenterol. 2013;19:1827–33.
22.
Zurück zum Zitat Ng SC, Tang W, Leong RW, et al. Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific. Gut. 2015;64:1063–71. Ng SC, Tang W, Leong RW, et al. Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific. Gut. 2015;64:1063–71.
24.
Zurück zum Zitat Hou JK, Lee D, Lewis J. Diet and inflammatory bowel disease: review of patient-targeted recommendations. Clin Gastroenterol Hepatol. 2014;12:1592–600.CrossRefPubMed Hou JK, Lee D, Lewis J. Diet and inflammatory bowel disease: review of patient-targeted recommendations. Clin Gastroenterol Hepatol. 2014;12:1592–600.CrossRefPubMed
25.
Zurück zum Zitat Ananthakrishnan AN, Khalili H, Song M, et al. High school diet and risk of Crohn’s disease and ulcerative colitis. Inflamm Bowel Dis. 2015;21:2311–9. Ananthakrishnan AN, Khalili H, Song M, et al. High school diet and risk of Crohn’s disease and ulcerative colitis. Inflamm Bowel Dis. 2015;21:2311–9.
26.
27.
Zurück zum Zitat Kuenzig ME, Lee SM, Eksteen B, et al. Smoking influences the need for surgery in patients with the inflammatory bowel diseases: a systematic review and meta-analysis incorporating disease duration. BMC Gastroenterol. 2016;16:143. Kuenzig ME, Lee SM, Eksteen B, et al. Smoking influences the need for surgery in patients with the inflammatory bowel diseases: a systematic review and meta-analysis incorporating disease duration. BMC Gastroenterol. 2016;16:143.
28.
Zurück zum Zitat Lunney PC, Kariyawasam VC, Wang RR, et al. Smoking prevalence and its influence on disease course and surgery in Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2015;42:61–70. Lunney PC, Kariyawasam VC, Wang RR, et al. Smoking prevalence and its influence on disease course and surgery in Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2015;42:61–70.
29.
Zurück zum Zitat Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci 1989;34:1841–54. Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci 1989;34:1841–54.
30.
Zurück zum Zitat Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol. 2006;101:1559–68. Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol. 2006;101:1559–68.
31.
Zurück zum Zitat Bergmann MM, Hernandez V, Bernigau W, et al. No association of alcohol use and the risk of ulcerative colitis or Crohn’s disease: data from a European Prospective cohort study (EPIC). Eur J Clin Nutr. 2017;71:512–8. Bergmann MM, Hernandez V, Bernigau W, et al. No association of alcohol use and the risk of ulcerative colitis or Crohn’s disease: data from a European Prospective cohort study (EPIC). Eur J Clin Nutr. 2017;71:512–8.
32.
Zurück zum Zitat Jiang L, Xia B, Li J, et al. Risk factors for ulcerative colitis in a Chinese population: an age-matched and sex-matched case-control study. J Clin Gastroenterol. 2007;41:280–4. Jiang L, Xia B, Li J, et al. Risk factors for ulcerative colitis in a Chinese population: an age-matched and sex-matched case-control study. J Clin Gastroenterol. 2007;41:280–4.
33.
Zurück zum Zitat Swanson GR, Sedghi S, Farhadi A, Keshavarzian A. Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease. Alcohol. 2010;44:223–8.CrossRefPubMedPubMedCentral Swanson GR, Sedghi S, Farhadi A, Keshavarzian A. Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease. Alcohol. 2010;44:223–8.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Anderson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med. 2001;344:808–14.CrossRef Anderson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med. 2001;344:808–14.CrossRef
35.
Zurück zum Zitat Kaplan GG, Jackson T, Sands BE, Frisch M, Andersson RE, Korzenik J. The risk of developing Crohn’s disease after an appendectomy: a meta-analysis. Am J Gastroenterol. 2008;103:2925–31.CrossRefPubMed Kaplan GG, Jackson T, Sands BE, Frisch M, Andersson RE, Korzenik J. The risk of developing Crohn’s disease after an appendectomy: a meta-analysis. Am J Gastroenterol. 2008;103:2925–31.CrossRefPubMed
36.
Zurück zum Zitat Moller FT, Andersen V, Wohlfahrt J, Jess T. Familial risk of inflammatory bowel disease: a population-based cohort study 1977-2011. Am J Gastroenterol. 2015;110:564–71.CrossRefPubMed Moller FT, Andersen V, Wohlfahrt J, Jess T. Familial risk of inflammatory bowel disease: a population-based cohort study 1977-2011. Am J Gastroenterol. 2015;110:564–71.CrossRefPubMed
37.
Zurück zum Zitat Orholm M, Fonager K, Sørensen HT. Risk of ulcerative colitis and Crohn’s disease among offspring of patients with chronic inflammatory bowel disease. Am J Gastroenterol. 1999;94:3236–8.CrossRefPubMed Orholm M, Fonager K, Sørensen HT. Risk of ulcerative colitis and Crohn’s disease among offspring of patients with chronic inflammatory bowel disease. Am J Gastroenterol. 1999;94:3236–8.CrossRefPubMed
38.
Zurück zum Zitat Wang PQ, Hu J, Al Kazzi ES, et al. Family history and disease outcomes in patients with Crohn’s disease: a comparison between China and the United States. World J Gastrointest Pharmacol Ther. 2016;7:556–63.CrossRefPubMedPubMedCentral Wang PQ, Hu J, Al Kazzi ES, et al. Family history and disease outcomes in patients with Crohn’s disease: a comparison between China and the United States. World J Gastrointest Pharmacol Ther. 2016;7:556–63.CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Kevans D, Silverberg MS, Borowski K, et al. IBD genetic risk profile in healthy first-degree relatives of Crohn’s disease patients. J Crohns Colitis. 2016;10:209–15. Kevans D, Silverberg MS, Borowski K, et al. IBD genetic risk profile in healthy first-degree relatives of Crohn’s disease patients. J Crohns Colitis. 2016;10:209–15.
40.
Zurück zum Zitat Ardizzone S, Puttini PS, Cassinotti A, Porro GB. Extraintestinal manifestations of inflammatory bowel disease. Dig Liver Dis. 2008 Jul;40 Suppl 2:S253–9.CrossRefPubMed Ardizzone S, Puttini PS, Cassinotti A, Porro GB. Extraintestinal manifestations of inflammatory bowel disease. Dig Liver Dis. 2008 Jul;40 Suppl 2:S253–9.CrossRefPubMed
41.
Zurück zum Zitat Isene R, Bernklev T, Høie O, et al. Extraintestinal manifestations in Crohn’s disease and ulcerative colitis: results from a prospective, population-based European inception cohort. Scand J Gastroenterol. 2015;50:300–5. Isene R, Bernklev T, Høie O, et al. Extraintestinal manifestations in Crohn’s disease and ulcerative colitis: results from a prospective, population-based European inception cohort. Scand J Gastroenterol. 2015;50:300–5.
Metadaten
Titel
Risk factors for inflammatory bowel disease: A prospective multi-center study
verfasst von
Anjali D. Amarapurkar
Deepak N. Amarapurkar
Pravin Rathi
Prabha Sawant
Nikhil Patel
Praful Kamani
Krishnakant Rawal
Rajiv Baijal
Ameya Sonawane
Nitin Narawane
Samrat Kolekar
Naveen Totla
Publikationsdatum
09.07.2018
Verlag
Springer India
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 3/2018
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-018-0850-0

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