Is Current smoking still an important environmental factor in inflammatory bowel diseases? Results from a population-based incident cohort

P. Lakatos, Zsuzsanna Vegh, Barbara D. Lovasz, Gyula David, T. Pandúr, Z. Erdélyi, Istvan Szita, G. Mester, Mihaly Balogh, Istvan Szipocs, Csaba Molnar, Erzsebet Komaromi, Michael Mandel, Agnes Horvath, M. Szathmári, Lajos S. Kiss, L. Lakatos

Research output: Article

49 Citations (Scopus)

Abstract

Background: Previous studies suggest that smoking is an important environmental factor in inflammatory bowel diseases (IBDs), with dichotomous effects in ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to analyze the relationship between smoking and IBD risk in a population-based database from Veszprem Province, which included incident cases diagnosed between January 1, 1977, and December 31, 2008. Methods: Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 years; CD: 506, age at diagnosis: 31.5 years). Both inpatient and outpatient records were collected and comprehensively reviewed. Overall, smoking frequency in the adult general population was 36.1%. Results: Of patients with CD, 47.2% were current smokers at diagnosis. Smoking was more frequent in male patients (P = 0.002) and was associated with an increased risk of CD (odds ratio, 1.96; 95% confidence interval, 1.63-2.37; P <0.001). In contrast, current smoking was protective against UC (odds ratio, 0.33; 95% confidence interval, 0.27-0.41). The effect of smoking was linked to gender (in CD, more deleterious in male patients) and age at diagnosis and was most prominent in young adults, with a difference already being seen in 18- to 19-year-olds. In CD, a change in disease behavior (P = 0.02), location from ileal or colonic to ileocolonic (P = 0.003), arthritis/arthropathy (P = 0.002), need for steroids (P = 0.06), or AZA (P = 0.038) was more common in current smokers. Smoking in UC was associated with more extensive disease (P = 0.01) and a tendency for decreased need for colectomy (P = 0.06). Conclusions: Current smoking was associated with the risk of IBD. This effect was linked to gender and age at diagnosis and was most prominent in young adults. No association was observed in pediatric or elderly patients. The deleterious and protective effects of smoking on the course in CD and UC were partially confirmed.

Original languageEnglish
Pages (from-to)1010-1017
Number of pages8
JournalInflammatory Bowel Diseases
Volume19
Issue number4
DOIs
Publication statusPublished - márc. 2013

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Inflammatory Bowel Diseases
Smoking
Crohn Disease
Ulcerative Colitis
Population
Young Adult
Odds Ratio
Confidence Intervals
Colectomy
Joint Diseases
Arthritis
Inpatients
Outpatients
Steroids
Databases
Pediatrics

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Is Current smoking still an important environmental factor in inflammatory bowel diseases? Results from a population-based incident cohort. / Lakatos, P.; Vegh, Zsuzsanna; Lovasz, Barbara D.; David, Gyula; Pandúr, T.; Erdélyi, Z.; Szita, Istvan; Mester, G.; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Mandel, Michael; Horvath, Agnes; Szathmári, M.; Kiss, Lajos S.; Lakatos, L.

In: Inflammatory Bowel Diseases, Vol. 19, No. 4, 03.2013, p. 1010-1017.

Research output: Article

Lakatos, P. ; Vegh, Zsuzsanna ; Lovasz, Barbara D. ; David, Gyula ; Pandúr, T. ; Erdélyi, Z. ; Szita, Istvan ; Mester, G. ; Balogh, Mihaly ; Szipocs, Istvan ; Molnar, Csaba ; Komaromi, Erzsebet ; Mandel, Michael ; Horvath, Agnes ; Szathmári, M. ; Kiss, Lajos S. ; Lakatos, L. / Is Current smoking still an important environmental factor in inflammatory bowel diseases? Results from a population-based incident cohort. In: Inflammatory Bowel Diseases. 2013 ; Vol. 19, No. 4. pp. 1010-1017.
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abstract = "Background: Previous studies suggest that smoking is an important environmental factor in inflammatory bowel diseases (IBDs), with dichotomous effects in ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to analyze the relationship between smoking and IBD risk in a population-based database from Veszprem Province, which included incident cases diagnosed between January 1, 1977, and December 31, 2008. Methods: Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 years; CD: 506, age at diagnosis: 31.5 years). Both inpatient and outpatient records were collected and comprehensively reviewed. Overall, smoking frequency in the adult general population was 36.1{\%}. Results: Of patients with CD, 47.2{\%} were current smokers at diagnosis. Smoking was more frequent in male patients (P = 0.002) and was associated with an increased risk of CD (odds ratio, 1.96; 95{\%} confidence interval, 1.63-2.37; P <0.001). In contrast, current smoking was protective against UC (odds ratio, 0.33; 95{\%} confidence interval, 0.27-0.41). The effect of smoking was linked to gender (in CD, more deleterious in male patients) and age at diagnosis and was most prominent in young adults, with a difference already being seen in 18- to 19-year-olds. In CD, a change in disease behavior (P = 0.02), location from ileal or colonic to ileocolonic (P = 0.003), arthritis/arthropathy (P = 0.002), need for steroids (P = 0.06), or AZA (P = 0.038) was more common in current smokers. Smoking in UC was associated with more extensive disease (P = 0.01) and a tendency for decreased need for colectomy (P = 0.06). Conclusions: Current smoking was associated with the risk of IBD. This effect was linked to gender and age at diagnosis and was most prominent in young adults. No association was observed in pediatric or elderly patients. The deleterious and protective effects of smoking on the course in CD and UC were partially confirmed.",
keywords = "Crohn's disease, Disease course, Disease risk, Smoking, Ulcerative colitis",
author = "P. Lakatos and Zsuzsanna Vegh and Lovasz, {Barbara D.} and Gyula David and T. Pand{\'u}r and Z. Erd{\'e}lyi and Istvan Szita and G. Mester and Mihaly Balogh and Istvan Szipocs and Csaba Molnar and Erzsebet Komaromi and Michael Mandel and Agnes Horvath and M. Szathm{\'a}ri and Kiss, {Lajos S.} and L. Lakatos",
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T1 - Is Current smoking still an important environmental factor in inflammatory bowel diseases? Results from a population-based incident cohort

AU - Lakatos, P.

AU - Vegh, Zsuzsanna

AU - Lovasz, Barbara D.

AU - David, Gyula

AU - Pandúr, T.

AU - Erdélyi, Z.

AU - Szita, Istvan

AU - Mester, G.

AU - Balogh, Mihaly

AU - Szipocs, Istvan

AU - Molnar, Csaba

AU - Komaromi, Erzsebet

AU - Mandel, Michael

AU - Horvath, Agnes

AU - Szathmári, M.

AU - Kiss, Lajos S.

AU - Lakatos, L.

PY - 2013/3

Y1 - 2013/3

N2 - Background: Previous studies suggest that smoking is an important environmental factor in inflammatory bowel diseases (IBDs), with dichotomous effects in ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to analyze the relationship between smoking and IBD risk in a population-based database from Veszprem Province, which included incident cases diagnosed between January 1, 1977, and December 31, 2008. Methods: Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 years; CD: 506, age at diagnosis: 31.5 years). Both inpatient and outpatient records were collected and comprehensively reviewed. Overall, smoking frequency in the adult general population was 36.1%. Results: Of patients with CD, 47.2% were current smokers at diagnosis. Smoking was more frequent in male patients (P = 0.002) and was associated with an increased risk of CD (odds ratio, 1.96; 95% confidence interval, 1.63-2.37; P <0.001). In contrast, current smoking was protective against UC (odds ratio, 0.33; 95% confidence interval, 0.27-0.41). The effect of smoking was linked to gender (in CD, more deleterious in male patients) and age at diagnosis and was most prominent in young adults, with a difference already being seen in 18- to 19-year-olds. In CD, a change in disease behavior (P = 0.02), location from ileal or colonic to ileocolonic (P = 0.003), arthritis/arthropathy (P = 0.002), need for steroids (P = 0.06), or AZA (P = 0.038) was more common in current smokers. Smoking in UC was associated with more extensive disease (P = 0.01) and a tendency for decreased need for colectomy (P = 0.06). Conclusions: Current smoking was associated with the risk of IBD. This effect was linked to gender and age at diagnosis and was most prominent in young adults. No association was observed in pediatric or elderly patients. The deleterious and protective effects of smoking on the course in CD and UC were partially confirmed.

AB - Background: Previous studies suggest that smoking is an important environmental factor in inflammatory bowel diseases (IBDs), with dichotomous effects in ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to analyze the relationship between smoking and IBD risk in a population-based database from Veszprem Province, which included incident cases diagnosed between January 1, 1977, and December 31, 2008. Methods: Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 years; CD: 506, age at diagnosis: 31.5 years). Both inpatient and outpatient records were collected and comprehensively reviewed. Overall, smoking frequency in the adult general population was 36.1%. Results: Of patients with CD, 47.2% were current smokers at diagnosis. Smoking was more frequent in male patients (P = 0.002) and was associated with an increased risk of CD (odds ratio, 1.96; 95% confidence interval, 1.63-2.37; P <0.001). In contrast, current smoking was protective against UC (odds ratio, 0.33; 95% confidence interval, 0.27-0.41). The effect of smoking was linked to gender (in CD, more deleterious in male patients) and age at diagnosis and was most prominent in young adults, with a difference already being seen in 18- to 19-year-olds. In CD, a change in disease behavior (P = 0.02), location from ileal or colonic to ileocolonic (P = 0.003), arthritis/arthropathy (P = 0.002), need for steroids (P = 0.06), or AZA (P = 0.038) was more common in current smokers. Smoking in UC was associated with more extensive disease (P = 0.01) and a tendency for decreased need for colectomy (P = 0.06). Conclusions: Current smoking was associated with the risk of IBD. This effect was linked to gender and age at diagnosis and was most prominent in young adults. No association was observed in pediatric or elderly patients. The deleterious and protective effects of smoking on the course in CD and UC were partially confirmed.

KW - Crohn's disease

KW - Disease course

KW - Disease risk

KW - Smoking

KW - Ulcerative colitis

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