在炎性肠疾病中，遗传因素与环境因素决定病程：一项基于人群的第一代和第二代移民队列研究

IF 4.5 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Inflammatory Bowel Diseases Pub Date : 2025-06-28 DOI:10.1093/ibd/izaf128

Anna-Teresa D'Hooghe, Gry Juul Poulsen, Christian Nikolai Sørensen, Parul Tandon, Nynne Nyboe Andersen, Séverine Vermeire, Bram Verstockt, Tine Jess

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引用次数: 0

摘要

背景：移民中炎症性肠病（IBD）的发病率与移民所在国的进展代近似，但对其疾病结局知之甚少。我们调查了移民一代如何影响IBD的预后。方法：在这项基于人群的队列研究中，比较了第一代和第二代移民（分为西方/非西方）和丹麦本地人的首次IBD相关住院、首次IBD相关手术、高级治疗需求和肛周疾病的风险，使用Cox比例风险回归来估计调整后的风险比（aHRs），校正了性别、IBD诊断时的年龄和IBD诊断的自然年份。结果：第一代移民的ibd相关手术风险较低(aHRWestern 0.89；95%置信区间[CI] 0.75 ~ 1.05, aHRnon-Western 0.79；95% CI, 0.67-0.92)和晚期治疗(aHRWestern 0.87；95% CI, 0.77-0.99, aHRnon-Western 0.83；95% CI, 0.74-0.94)，而第二代移民与丹麦本地人相似。然而，第二代移民比本土丹麦人有更高的住院风险(aHRWestern 1.28；95% CI, 1.05-1.55, aHRnon-Western 1.40；95% CI, 1.28-1.54)，而在第一代移民中，仅在非西方溃疡性结肠炎患者中观察到这种情况(aHR 1.19；95% ci, 1.08-1.32)。在两代人中，非西方移民有更高的肛周疾病风险(克罗恩病：ahr，第一代1.55；95% ci, 1.25-1.92；aHRsecond-generation 1.58;95% ci, 1.25-2.01)。结论：各代移民的疾病结局不同，环境因素可能影响病程，有待进一步调查。相比之下，非西方移民在两代人中都有更多的肛周疾病，这表明这种使人衰弱的表型具有遗传易感性。

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Unraveling Genetic Versus Environmental Factors Determining Disease Course in Inflammatory Bowel Diseases: A Population-Based Cohort Study in First- and Second-Generation Immigrants.

Background: Inflammatory bowel diseases (IBD) incidence in immigrants approximates that of the host country in progressive generations but less is known about their disease outcome. We investigate how the immigrant generation affects IBD outcomes.

Methods: In this population-based cohort study, the risks of first IBD-related hospitalization, first IBD-related surgery, need for advanced therapies, and perianal disease were compared between first- and second-generation immigrants (stratified into Western/non-Western) and native Danes, using Cox proportional hazard regression to estimate adjusted hazard ratios (aHRs), correcting for sex, age at IBD diagnosis, and calendar year of IBD diagnosis.

Results: First-generation immigrants had lower risk of IBD-related surgery (aHRWestern 0.89; 95% confidence interval [CI] 0.75-1.05, aHRnon-Western 0.79; 95% CI, 0.67-0.92) and advanced therapy (aHRWestern 0.87; 95% CI, 0.77-0.99, aHRnon-Western 0.83; 95% CI, 0.74-0.94) than native Danes, whereas second-generation immigrants resembled native Danes. However, second-generation immigrants had higher risk of hospitalization than native Danes (aHRWestern 1.28; 95% CI, 1.05-1.55, aHRnon-Western 1.40; 95% CI, 1.28-1.54), whereas in first-generation immigrants this was only observed in non-Western ulcerative colitis patients (aHR 1.19; 95% CI, 1.08-1.32). Across both generations, non-Western immigrants had higher risk of perianal disease (Crohn's disease: aHRfirst-generation 1.55; 95% CI, 1.25-1.92; aHRsecond-generation 1.58; 95% CI, 1.25-2.01).

Conclusions: Disease outcomes change across immigrant generations, pointing to environmental factors possibly impacting disease course, which needs further investigation. In contrast, non-Western immigrants were shown to have more perianal disease in both generations, suggesting a genetic susceptibility for this debilitating phenotype.

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来源期刊

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.