Is Current Smoking Still an Important Environmental Factor in Inflammatory Bowel Diseases? Results from a Population-based Incident Cohort
| Autor: | Laszlo Lakatos, Peter L. Lakatos, Mihaly Balogh, Lajos S. Kiss, Istvan Szipocs, C. Molnar, Agnes Horvath, Zsuzsanna Vegh, M Mandel, Zsuzsanna Erdelyi, Barbara D. Lovasz, Miklós Szathmári, Petra A. Golovics, Istvan Szita, Tunde Pandur, Erzsebet Komaromi, Gyula David, Gabor Mester |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Population Cohort Studies Young Adult Crohn Disease Risk Factors Internal medicine medicine Humans Immunology and Allergy Young adult education Aged Hungary education.field_of_study Crohn's disease business.industry Smoking Gastroenterology Environmental Exposure Odds ratio Middle Aged Prognosis medicine.disease Ulcerative colitis Confidence interval Cohort Colitis Ulcerative Female business Follow-Up Studies Cohort study |
| Zdroj: | Inflammatory Bowel Diseases. 19:1010-1017 |
| ISSN: | 1078-0998 |
| Popis: | BACKGROUND Previous studies suggest that smoking is an important environmental factor in inflammatory bowel diseases (IBDs), with dichotomous effects in ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to analyze the relationship between smoking and IBD risk in a population-based database from Veszprem Province, which included incident cases diagnosed between January 1, 1977, and December 31, 2008. METHODS Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 years; CD: 506, age at diagnosis: 31.5 years). Both inpatient and outpatient records were collected and comprehensively reviewed. Overall, smoking frequency in the adult general population was 36.1%. RESULTS Of patients with CD, 47.2% were current smokers at diagnosis. Smoking was more frequent in male patients (P = 0.002) and was associated with an increased risk of CD (odds ratio, 1.96; 95% confidence interval, 1.63-2.37; P < 0.001). In contrast, current smoking was protective against UC (odds ratio, 0.33; 95% confidence interval, 0.27-0.41). The effect of smoking was linked to gender (in CD, more deleterious in male patients) and age at diagnosis and was most prominent in young adults, with a difference already being seen in 18- to 19-year-olds. In CD, a change in disease behavior (P = 0.02), location from ileal or colonic to ileocolonic (P = 0.003), arthritis/arthropathy (P = 0.002), need for steroids (P = 0.06), or AZA (P = 0.038) was more common in current smokers. Smoking in UC was associated with more extensive disease (P = 0.01) and a tendency for decreased need for colectomy (P = 0.06). CONCLUSIONS Current smoking was associated with the risk of IBD. This effect was linked to gender and age at diagnosis and was most prominent in young adults. No association was observed in pediatric or elderly patients. The deleterious and protective effects of smoking on the course in CD and UC were partially confirmed. |
| Databáze: | OpenAIRE |
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