Exposome Signatures of Gastrointestinal Disorders Among Active Duty Service Members

Area of Science:

• Military Health
• Exposomics
• Gastrointestinal Disorders

Background:

• Gastrointestinal disorders (GD) pose a significant health concern within military populations.
• An exposomic approach was utilized to identify risk factors for GD in the Army and Marine Aviation Community (AMAC).
• Understanding these factors is crucial for improving the health and readiness of service members.

Purpose of the Study:

• To determine medical and operational risk factors associated with reported gastrointestinal disorders (GD) in the Military Health System.
• To apply an exposomic framework to analyze GD incidence within the AMAC.
• To identify specific demographic and lifestyle factors correlating with GD risk.

Main Methods:

• A retrospective cohort study analyzed longitudinal data from 79,249 active duty United States AMAC service members (ADSMs) from October 2015 to December 2019.
• Data were sourced from the Medical Assessment and Readiness System (MARS).
• Multivariable mixed-effects logistic regression assessed associations between GD incidence and factors including rank, service time, deployment, Armed Forces Qualification Test score, education, tobacco use, alcohol use, age, gender, race, ethnicity, body mass index (BMI), and marital status.

Main Results:

• The study observed an incidence rate of 2.2 per 100 person-years and a period prevalence of 3.2% for GD.
• GD was independently associated with higher rank, longer service time, and deployment (P < 0.05).
• Specific high-risk categories included age, BMI, race (not ethnicity), marital status, and service time.

Conclusions:

• White ADSMs older than 33 years, with longer service, deployments, and who are married, exhibit a higher risk for GD.
• Deployment time, rather than geographical location, was identified as a significant risk factor for GD.
• The study highlights the utility of exposomic approaches for developing personalized clinical algorithms for health outcomes in military populations.