GUT：炎性肠病与生活方式相关

　　近日，一项关于多个国家和地区的研究指出，炎性肠病（IBD）随时间及地理而变化的流行病学提示环境因素在疾病表达的改变中发挥重要作用。该疾病在发展中国家的出现提示流行病学进展与西方化的生活方式以及工业化相关。该文发表在2013年第63卷第4期《消化道》（GUT）杂志上。

　　来自香港的Siew Ng医师指出，已发现的最强的环境相关因素为吸烟和阑尾切除，不过两种因素均不足以单独解释全球炎性肠病发病率的差异。

　　城市化及伴随的饮食习惯改变、抗生素应用、卫生状况、微生物暴露和污染均成为炎性肠病可能的环境危险因素。

　　研究团队对不同地理区域和人群中可能存在差异的社会经济状况的改变进行了评价，因而重要的是考虑到不同患者的危险因素的异质性。

　　研究团队发现个体、家庭、社区、地方及地区来源的危险因素均可能在炎性肠病的发病中发挥作用。

　　Ng医师及其同事补充道：“炎性肠病的地理差异为研究者提供了评价可能存在的环境病因因素的线索”。“本文旨在对评价炎性肠病的地理差异的文献做一最新综述，对有可能解释这种差异的环境危险因素进行评价。”

与肠病相关的拓展阅读：

• JAMA Dermatol：异维甲酸或不会升高女性炎症性肠病风险
• INFLAMM BOWEL DIS：中国儿童炎症性肠病报告
• Science：新研究有助开发治疗炎性肠病新方法
• 全国肛肠病流调启动
• 炎症性肠病治疗推崇长效低毒策略
更多信息请点击：有关肠病更多资讯

Geographical variability and environmental risk factors in inflammatory bowel disease

Abstract

The changing epidemiology of inflammatory bowel disease (IBD) across time and geography suggests that environmental factors play a major role in modifying disease expression. Disease emergence in developing nations suggests that epidemiological evolution is related to westernisation of lifestyle and industrialisation. The strongest environmental associations identified are cigarette smoking and appendectomy, although neither alone explains the variation in incidence of IBD worldwide. Urbanisation of societies, associated with changes in diet, antibiotic use, hygiene status, microbial exposures and pollution have been implicated as potential environmental risk factors for IBD. Changes in socioeconomic status might occur differently in different geographical areas and populations and, consequently, it is important to consider the heterogeneity of risk factors applicable to the individual patient. Environmental risk factors of individual, familial, community-based, country-based and regionally based origin may all contribute to the pathogenesis of IBD. The geographical variation of IBD provides clues for researchers to investigate possible environmental aetiological factors. The present review aims to provide an update of the literature exploring geographical variability in IBD and to explore the environmental risk factors that may account for this variability.