Familial risk of inflammatory bowel disease: A population-based cohort study 1977-2011.

Bidragets oversatte titel: Den familiære risiko for inflammatorisk tarmsygdom. : Et pupulations baseret kohortestudie fra 1977 til 2011

Frederik Trier Møller, Vibeke Andersen, Tine Jess, Jan Wohlfart

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Abstrakt

Background
The inflammatory bowel diseases (IBD) – ulcerative colitis (UC) and Crohn’s disease (CD) - are caused by complex gene-environment interactions. This study provides updated familial aggregation patterns in a large population-based Danish IBD cohort.
Methods:
Our cohort study was based on the entire Danish population during 1977-2011 (n=8,295,773). Through a unique personal identification number assigned to each Danish citizen, sex, date and location of birth, identity of parents, and information on vital status and emigration were available. This information was used to establish kinship in the entire population. Individuals receiving at least 2 diagnoses of IBD during the time period (n=45,780) were identified using the Danish National Registry of Patients. Risk of IBD in family members to individuals with IBD was assessed by Poisson regression analysis.
Results:
The overall proportion of familial CD cases was 12,15 percent of total CD cases and familial UC accounted for and 8,84 percent of total UC cases from 2007-2011. Patterns of IBD risk in family members to IBD-affected individuals appear from Table 1. The risk of CD was 9-fold increased in 1. degree relatives to at least two individuals with IBD, 7.8 -fold increased in 1. degree relatives to one family member with CD, and even 2.8-fold increased if the 1. degree relative had UC. The same pattern was observed for risk of UC. Second-degree relatives to patients with CD or UC were also at significantly increased risk not only of the same but also the other subtype of IBD, whereas the risk of IBD was less pronounced in third degree relatives to individuals with IBD.
Table 1
Rate ratio RR (95% CI) of contracting CD in family members to an IBD affected case, as compared to having a relative of the same type without a diagnosis of IBD.
Type of exposure/type of relative. 1. degree relative 2. degree relative 3. degree relative
Two or more relatives with CD or UC 9.36(6.75-12.99) 3.29(2.04-5.31) 0,71(0.10-5.06)
One CD relative 7.78(7.07-8.57) 2.44(2.01-2.97) 1.88(1.30-2.71)
One UC relative 2.82(2.51-3.16) 1.56(1.30-1.87) 1.35(0.90-2.02)

Rate ratio RR (95% CI) of contracting UC in family members to an IBD affected case, as compared to having a relative of the same type without a diagnosis of IBD.

Type of exposure/type of relative. 1. degree relative 2. degree relative 3. degree relative
Two or more relatives with CD or UC 6.92(5.28-9.06) 2.62(1.63-4.23) 1.15(0.29-4.62)
One CD relative 2.57(2.28-2.90) 1.51(1.22-1.86) 1.47(1.00-2.17)
One UC relative 4.09(3.81-4.38) 1.85(1.60-2.13) 1.51(1.07-2.13)
Conclusion:
This large-scale population-based study provides updated numbers of familial aggregation of IBD. Familial exposure to CD not only increases the risk of CD but also of UC markedly and vice versa, and the ratio rises with closer familial ties and in families with multiple affected members. Furthermore family cases attributes to a higher percentage of all family cases than previously reported- when adjusting for time period.
Bidragets oversatte titelDen familiære risiko for inflammatorisk tarmsygdom. : Et pupulations baseret kohortestudie fra 1977 til 2011
OriginalsprogEngelsk
Publikationsdato26. feb. 2014
Antal sider1
StatusUdgivet - 26. feb. 2014

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