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基于早期生命风险因素的炎症性肠病预测在基于人口的队列队列中
Manasi Agrawal1, Anne Vinkel Hansen2, Mette Julsgaard3
1The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark.
生命早期的暴露可以预测炎症性肠病 (IBD) 风险,特别是较年轻发病的性结肠炎 (UC). 预测模型显示,高风险群体的IBD发病率较高.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 流行病学 流行病学
- 计算生物学 计算生物学
背景情况:
- 早期暴露与炎症性肠病 (IBD) 有关,但缺乏风险预测模型.
- 了解这些早期风险因素对于及时干预和治疗IBD至关重要.
- 该研究解决了IBD病因学预测工具的需求.
研究的目的:
- 开发和验证基于生命早期暴露的IBD风险的预测模型.
- 评估这些模型在不同年龄预测IBD发病时的准确性.
- 确定导致IBD发展的关键早期生活因素.
主要方法:
- 全国基于人口的队列研究,使用丹麦国家出生队列.
- 包括关于早期生命暴露的采访数据的后代,直到IBD诊断或研究结束 (2022年9月1日) 进行跟踪.
- 在IBD预测模型中使用可克斯回归的弹性网,并使用引导进行内部验证.
主要成果:
- 50,592个后代被跟踪了平均21.8年; 310人患有IBD (0.6%).
- 预测模型显示中度准确性 (AUC为整体IBD的0.560.69,UC发病期<13年为0.76).
- 在前5%预测的风险人群中,累积发病率高出1.6至26倍;关键预测因素包括父母的IBD,卫生,饮食和感染.
结论:
- 早期生命暴露是性结肠炎 (UC) 的预测因素,特别是在年轻发病的疾病中.
- 与UC相比,克罗恩病 (CD) 的预测准确性不那么强大.
- 这些发现突显了使用早期生命数据来分层IBD风险的潜力.
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