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Higher Sun Exposure is Associated With Lower Risk of Pediatric Inflammatory Bowel Disease: A Matched Case-control
Elizabeth Ann Holmes1, Anne-Louise Ponsonby2,3, Angela Pezic2
1National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra.
Insights
Increased sun exposure may lower the risk of pediatric inflammatory bowel disease (IBD). This study found higher sun exposure was linked to reduced odds of developing IBD in children.
Area of Science:
- Pediatric Gastroenterology
- Environmental Epidemiology
- Dermatology
Background:
- Global incidence of pediatric inflammatory bowel disease (IBD) is rising.
- Ecological studies suggest a link between higher latitude, lower UV radiation, and increased IBD rates.
- Individual-level data on sun exposure and pediatric IBD risk are lacking.
Purpose of the Study:
- To investigate the association between past sun exposure and the risk of developing pediatric inflammatory bowel disease (IBD).
- To assess if individual sun exposure patterns correlate with IBD incidence in children.
Main Methods:
- A case-control study involving children (0-17 years) diagnosed with IBD and healthy controls.
- Data collected via questionnaires on demographics, sun exposure history, sun sensitivity, sun protection use, physical activity, and parental factors.
- Conditional logistic regression used to analyze the association between sun exposure and IBD status, adjusting for confounders.
Main Results:
- A total of 99 IBD cases and 396 controls were analyzed after matching.
- Each 10-minute increase in leisure-time sun exposure (summer or winter) was associated with a 6% linear reduction in the odds of having IBD (P=0.002).
- Sensitivity analyses confirmed the association across various subgroups and adjustments.
Conclusions:
- Higher sun exposure, both in summer and winter, is associated with a reduced risk of pediatric inflammatory bowel disease (IBD).
- Plausible biological mechanisms may explain the observed inverse relationship between sun exposure and IBD risk.
Objectives:
The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide. Ecological studies show higher incidence in regions at higher latitude or lower ambient ultraviolet radiation; individual-level associations with sun exposure have not been assessed.
Methods:
We recruited children (0-17 years) with IBD from 2 large hospitals in Melbourne, Australia. Control participants were recruited from the day surgery unit of one of the same hospitals. Questionnaires provided data on demographics, past sun exposure, the likelihood of sunburn (skin sensitivity) or tanning following sun exposure, use of sun protection, physical activity, and parental smoking and education. Grandparent ancestry was used to determine participant ethnicity. Cases and controls were matched on age and sex. We used conditional logistic regression to test the association between being an IBD case and past sun exposure at different ages, adjusted for a range of other factors.
Results:
After matching, n = 99 cases and n = 396 controls were included in the analysis. In multivariable analysis, for each 10 min increment in leisure-time sun exposure in summer or winter there was a linear 6% reduction in the odds of having IBD (P = 0.002). Results were similar in sensitivity analyses including only the most recently diagnosed cases, only Caucasian cases and controls, only those with symptom onset within the year before study entry, or additionally adjusted for age or physical activity.
Conclusions:
Higher sun exposure in the previous summer or winter was associated with a reduced risk of having IBD. There are plausible pathways that could mediate this effect.
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