Adjoa Anyane-Yeboa, Kevin Casey, Andrea L Roberts, Emily Lopes, Kristin Burke, Ashwin Ananthakrishnan, James Richter, Yvette C Cozier, Karenstan C Koenen, Andrew T Chan, Hamed Khalili
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Diagnosis of IBD was determined by self-report and confirmed independently by two physicians through review of medical records. We used Cox proportional hazard modeling to estimate the risk of Crohn's disease (CD) and ulcerative colitis (UC) while adjusting for covariates.</p><p><strong>Results: </strong>Among 68,167 women followed from 1989 until 2017, there were 146 incident cases of CD and 215 incident cases of UC. Compared to women with no history of abuse, the adjusted hazard ratios of CD were 1.16 (95% CI 0.67 - 2.02) for mild, 1.58 (95% CI 0.92 - 2.69) for moderate, and 1.95 (95% CI 1.22 - 3.10) for severe abuse (Ptrend = 0.002). We did not observe an association between childhood abuse and risk of UC.</p><p><strong>Conclusions: </strong>Women who reported early life severe abuse had an increased risk of CD. 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引用次数: 0
摘要
简介以前曾有报道称炎症性肠病(IBD)、生活压力事件和心理因素之间存在联系。我们的目的是通过一个大型女性卫生专业人员队列来研究童年情感、身体和性虐待与 IBD 风险之间的关系:我们的研究对象包括 2001 年参加护士健康研究 II 并填写了童年创伤问卷中的身体和情感虐待分量表以及亲子冲突策略量表中的性虐待量表的人员。IBD 诊断通过自我报告确定,并由两名医生通过查看病历独立确认。我们使用 Cox 比例危险模型来估算克罗恩病(CD)和溃疡性结肠炎(UC)的发病风险,同时调整协变量:从1989年到2017年,在68 167名女性中,有146例CD和215例UC病例。与无虐待史的女性相比,轻度虐待的CD调整危险比为1.16(95% CI 0.67 - 2.02),中度虐待的CD调整危险比为1.58(95% CI 0.92 - 2.69),重度虐待的CD调整危险比为1.95(95% CI 1.22 - 3.10)(Ptrend = 0.002)。我们没有观察到童年虐待与 UC 风险之间的关联:结论:报告早期遭受严重虐待的女性罹患 CD 的风险更高。这些数据为越来越多的证据增添了新的内容,这些证据表明早期生活中的压力因素对 CD 的发展起着至关重要的作用。
Association of Childhood Abuse with Incident Inflammatory Bowel Disease.
Introduction: A link between inflammatory bowel disease (IBD), stressful life events and psychological factors has previously been reported. Our objective was to examine the relationship between childhood emotional, physical, and sexual abuse and risk of IBD using a large cohort of female health professionals.
Methods: We included participants in the Nurses' Health Study II who completed the Physical and Emotional Abuse Subscale of the Childhood Trauma Questionnaire and the Sexual Maltreatment Scale of the Parent-Child Conflict Tactics Scale in 2001. Diagnosis of IBD was determined by self-report and confirmed independently by two physicians through review of medical records. We used Cox proportional hazard modeling to estimate the risk of Crohn's disease (CD) and ulcerative colitis (UC) while adjusting for covariates.
Results: Among 68,167 women followed from 1989 until 2017, there were 146 incident cases of CD and 215 incident cases of UC. Compared to women with no history of abuse, the adjusted hazard ratios of CD were 1.16 (95% CI 0.67 - 2.02) for mild, 1.58 (95% CI 0.92 - 2.69) for moderate, and 1.95 (95% CI 1.22 - 3.10) for severe abuse (Ptrend = 0.002). We did not observe an association between childhood abuse and risk of UC.
Conclusions: Women who reported early life severe abuse had an increased risk of CD. These data add to the growing body of evidence on the critical role of early life stressors in development of CD.
期刊介绍:
Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease.
Colon and small bowel
Endoscopy and novel diagnostics
Esophagus
Functional GI disorders
Immunology of the GI tract
Microbiology of the GI tract
Inflammatory bowel disease
Pancreas and biliary tract
Liver
Pathology
Pediatrics
Preventative medicine
Nutrition/obesity
Stomach.