Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific.


OBJECTIVE The rising incidence of inflammatory bowel disease in Asia supports the importance of environmental risk factors in disease aetiology. This prospective population-based case-control study in Asia-Pacific examined risk factors prior to patients developing IBD. DESIGN 442 incident cases (186 Crohn's disease (CD); 256 UC; 374 Asians) diagnosed between 2011 and 2013 from eight countries in Asia and Australia and 940 controls (frequency-matched by sex, age and geographical location; 789 Asians) completed an environmental factor questionnaire at diagnosis. Unconditional logistic regression models were used to estimate adjusted ORs (aOR) and 95% CIs. RESULTS In multivariate model, being breast fed >12 months (aOR 0.10; 95% CI 0.04 to 0.30), antibiotic use (aOR 0.19; 0.07 to 0.52), having dogs (aOR 0.54; 0.35 to 0.83), daily tea consumption (aOR 0.62; 0.43 to 0.91) and daily physical activity (aOR 0.58; 0.35 to 0.96) decreased the odds for CD in Asians. In UC, being breast fed >12 months (aOR 0.16; 0.08 to 0.31), antibiotic use (aOR 0.48; 0.27 to 0.87), daily tea (aOR 0.63; 0.46 to 0.86) or coffee consumption (aOR 0.51; 0.36 to 0.72), presence of hot water tap (aOR 0.65; 0.46 to 0.91) and flush toilet in childhood (aOR 0.71; 0.51 to 0.98) were protective for UC development whereas ex-smoking (aOR 2.02; 1.22 to 3.35) increased the risk of UC. CONCLUSIONS This first population-based study of IBD risk factors in Asia-Pacific supports the importance of childhood immunological, hygiene and dietary factors in the development of IBD, suggesting that markers of altered intestinal microbiota may modulate risk of IBD later in life.

DOI: 10.1136/gutjnl-2014-307410

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@article{Ng2015EnvironmentalRF, title={Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific.}, author={S C Ng and Whitney Tang and Rupert W L Leong and Min-hu Chen and Yanna Ko and Corrie Studd and O Niewiadomski and Sally J Bell and M. Kamm and Hithanadura Janaka de Silva and Anuradhani Kasturiratne and Yasith Udara Senanayake and Choon Jin Ooi and Khoon-Lin Ling and David Eng Hui Ong and Khean Lee Goh and Ida Hilmi and Qin Ouyang and Yu-Fang Wang and Pinjin Hu and Zhenhua Zhu and Zhirong Zeng and Kaichun Wu and Xin Wang and Bing Xia and Jin Li and Pises Pisespongsa and Sathaporn Manatsathit and Satimai Aniwan and Marcellus Simadibrata and Murdani Abdullah and Steve Tsang and Tai Chiu Wong and Aric J Hui and Chung Mo Chow and Hon Ho Yu and Mo Fong Li and Ka Kei Ng and Jessica Y. L. Ching and Justin C. Y. Wu and Francis K L Chan and Joseph J. Y. Sung}, journal={Gut}, year={2015}, volume={64 7}, pages={1063-71} }