Risk factors for inflammatory bowel diseases according to the "hygiene hypothesis": A case-control, multi-centre, prospective study in Southern Italy

被引:72
作者
Castiglione, Fabiana [1 ]
Diaferia, Maria
Morace, Fabrizio [2 ]
Labianca, Orazio [3 ]
Meucci, Costantino [4 ]
Cuomo, Antonio [5 ]
Panarese, Antonio [6 ]
Romano, Marco [7 ]
Sorrentini, Italo [8 ]
D'Onofrio, Caterina
Caporaso, Nicola
Rispo, Antonio
机构
[1] Univ Naples Federico II, Fac Med & Chirurg, I-80131 Naples, Italy
[2] Osped San Gennaro Napoli, Naples, Italy
[3] Osped Fucito, Mercato San Severino, Italy
[4] Osped Maresca, Torre Del Greco, Italy
[5] Osped Umberto 1, Nocera Inferiore, Italy
[6] Osped Santa Maria delle Grazie, Pozzuoli, Italy
[7] Univ Naples 2, Naples, Italy
[8] Osped Rummo, Benevento, Italy
关键词
Crohn's disease; Ulcerative colitis; IBD; Hygiene hypothesis; Epidemiology; CROHNS-DISEASE; ULCERATIVE-COLITIS; OLMSTED COUNTY; IBD; SMOKING; EPIDEMIOLOGY; APPENDECTOMY; PREVALENCE; MINNESOTA; SURVIVAL;
D O I
10.1016/j.crohns.2011.09.003
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
Background: Ulcerative colitis (UC) and Crohn's disease (CD) are inflammatory bowel diseases (IBD) of unknown aetiology. The 'hygiene hypothesis' (HH) suggests that several hygiene-related factors may have contributed to the increased incidence of IBD. The aim of the study was to evaluate risk factors for IBD related to HH in a cohort of IBD patients from the south of Italy. Methods: We prospectively performed a one-year, questionnaire-based, case control, multi-centre study focusing on the principal risk factors for IBD according to HH. We investigated the main surrogate markers of HH (helmintic infections and antibiotics in childhood; breastfeeding; family size/sibship; urban upbringing; personal and domestic hygiene in childhood) in UC and CD patients, in comparison with a control group of healthy subjects. In addition, the traditional risk factors for IBD were also recorded. Results: The study population included 527 cases of UC, 468 CD and 562 controls. None of the surrogate risk factors of HH was significantly associated with IBD. On the contrary, the traditional risk factors confirmed their statistical significance in this IBD population. Familial aggregation: OR 4.07 for UC; OR 4.83 for CD; smoking: OR 0.38 for UC; OR 1.40 for CD; appendectomy: OR 0.28 for UC; OR 1.61 for CD. Conclusion: Even though risk factors associated to the HH have been proposed as a possible explanation for the increasing calendar trend of IBD incidence, their role does not appear to be statistically significant. Familial aggregation, smoking habits and appendectomy still remain the main risk factors associated with IBD. (C) 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:324 / 329
页数:6
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