RESEARCH - Risk factors for inflammatory bowel disease in the general population

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Alimentary Pharmacology & Therapeutics

Volume 22 Issue 4 Page 309-315, August 2005

Abstract

Risk factors for inflammatory bowel disease in the general population

L. A. GARCÍA RODRÍGUEZ**Centro Español de Investigación

Farmacoepidemiológica (CEIFE), Madrid, Spain, A.

GONZÁLEZ-PÉREZ**Centro Español de Investigación Farmacoepidemiológica

(CEIFE), Madrid, Spain, , S. JOHANSSON†‡†AstraZeneca R & D Mölndal,

Sweden‡Section of Preventive Cardiology, Göteborg University, Sweden &

M.-A. WALLANDER†§†AstraZeneca R & D Mölndal, Sweden§Department of Public

Health and Caring Science, Uppsala University, Sweden*Centro Español

de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain;

†AstraZeneca R & D Mölndal, Sweden; ‡Section of Preventive Cardiology,

Göteborg University, Sweden; §Department of Public Health and Caring

Science, Uppsala University, Sweden

Dr A. González-Pérez, C/Almirante 28-2, 28004 Madrid, Spain.

Summary

Background: The aetiology of inflammatory bowel disease remains largely unknown.

Aim: We performed a comprehensive assessment of potential risk factors

associated with the occurrence of inflammatory bowel disease.

Methods: We identified a cohort of patients 20–84 years old between

1995 and 1997 registered in the General Practitioner Research Database

in the UK. A total of 444 incident cases of IBD were ascertained and

validated with the general practitioner. We performed a nested

case–control analysis using all cases and a random sample of 10 000

frequency-matched controls.

Results: Incidence rates for ulcerative colitis, Crohn's disease, and

indeterminate colitis were 11, 8, and 2 cases per 100 000

person-years, respectively. Among women, we found that long-term users

of oral contraceptives were at increased risk of developing UC (OR:

2.35; 95% CI: 0.89–6.22) and CD (OR: 3.15; 95% CI: 1.24–7.99).

Similarly, long-term users of HRT had an increased risk of CD (OR:

2.60; 95% CI: 1.04–6.49) but not UC. Current smokers experienced a

reduced risk of UC along with an increased risk of CD. Prior

appendectomy was associated with a decreased the risk of UC (OR: 0.37;

95% CI: 0.14–1.00).

Conclusions: Our results support the hypothesis of an increased risk

of inflammatory bowel disease associated with oral contraceptives use

and suggest a similar effect of hormone replacement therapy on CD. We

also confirmed the effects of smoking and appendectomy on inflammatory

bowel disease.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2005.02564.x

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Not an MD