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Environmental factors and risk of developing paediatric inflammatory bowel disease -- a population based study
Christian Jakobsen1, Anders Paerregaard, Pia Munkholm
1Department of Paediatrics, Copenhagen University Hospital, Hvidovre, Denmark. Christian.jakobsen@hvh.regionh.dk
Insights
Environmental factors like genetics, bedroom sharing, high sugar intake, and prior infections increase pediatric inflammatory bowel disease (IBD) risk. Vegetable and whole meal bread consumption appear protective.
Area of Science:
- Pediatric Gastroenterology
- Environmental Epidemiology
- Inflammatory Bowel Disease Etiology
Background:
- Inflammatory Bowel Disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC).
- Understanding environmental risk factors is crucial for pediatric IBD pathogenesis.
- This study focuses on children under 15 years of age.
Purpose of the Study:
- To identify environmental risk factors for developing IBD in children.
- To explore protective factors against pediatric IBD.
- To investigate differences in risk factors between CD and UC.
Main Methods:
- Prospective recruitment of IBD patients and healthy controls in Denmark (2007-2009).
- Data collection via questionnaires on socioeconomic status, living conditions, infections, and diet.
- Statistical analysis using odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- Identified risk factors: IBD in first-degree relatives (OR 6.1), bedroom sharing (OR 2.1), high sugar intake (OR 2.5), prior gastrointestinal infections (OR 7.7), and stressful events (OR 1.7).
- Protective factors: daily vegetable consumption (CD OR 0.3, UC OR 0.3) and whole meal bread (IBD OR 0.5).
- Increased CD risk in urban areas (OR 1.3) compared to UC.
Conclusions:
- Several environmental factors significantly influence the risk of pediatric IBD.
- Dietary habits and exposure to infections are key modifiable factors.
- Further research into environmental influences is vital for understanding IBD etiology and phenotypes.
Background And Aims:
To identify environmental risk factors for developing inflammatory bowel disease (IBD) in children <15 years of age.
Methods:
IBD patients and randomly selected healthy controls from a well defined geographical area in Denmark were prospectively recruited in the period 1.1.2007-31.12.2009. Data regarding socioeconomic status, area of residence, living conditions, infections and diet were obtained by a questionnaire.
Results:
A total of 118 IBD patients (59 Crohn's disease (CD), 56 ulcerative colitis (UC) and 3 IBD unclassified (IBDU)) and 477 healthy controls filled out the questionnaire. The response rates were 91% in patients and 45% in controls, respectively. Several risk factors for IBD were identified: IBD in first degree relatives (IBD: OR (odds ratio): 6.1 (95%CI: 2.5-15.0), CD (OR: 6.8 (2.3-20.2)) and UC (OR: 6.1 (2.3-16.0))); bedroom sharing (IBD: OR: 2.1 (1.0-4.3), CD (OR: 3.6 (1.3-9.4))); high sugar intake (IBD: OR: 2.5 (1.0-6.2), CD (OR: 2.9 (1.0-8.5))); prior admission to a hospital for gastrointestinal infections (IBD: 7.7 (3.1-19.1), CD (7.9 (2.5-24.9)) and UC (7.4 (2.5-21.6))); stressful events (IBD: 1.7 (1.0-2.9)). Protective factors were daily vs. less than daily vegetable consumption (CD: 0.3 (0.1-1.0), UC (0.3 (0.1-0.8))) and whole meal bread consumption (IBD: OR: 0.5 (0.3-0.9), CD (0.4 (0.2-0.9))). An increased risk of diagnosis of CD compared to UC was shown for patients living in more urban areas (OR: 1.3 (1.1-1.6)).
Conclusion:
We identified several risk and protective factors for developing IBD. Studies on the influence of environmental factors are important in our understanding of aetiology and phenotypes of paediatric IBD.
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