Genetic risk and modifiable lifestyle factors are independently associated with the risk of developing inflammatory bowel disease (IBD) in adulthood, according to a new report.
Additionally, adherence to a healthy lifestyle was associated with a nearly 50% lower risk of developing Crohn’s disease or ulcerative colitis in those at high genetic risk.
“Although it is well known to have an onset in childhood and early adulthood, epidemiological studies now highlight the increasing incidence and prevalence of IBD with onset in middle or late adulthood,” said the public. Xue Li, lead author of the Big Data Department of the School of Health, writes. Health and Colleagues, Zhejiang University School of Medicine, Hangzhou, China.
“Compared with IBD in children and adolescents, the etiology of adult-onset IBD is thought to be more multifactorial, with genetic and environmental factors playing important roles in its development,” they said. is writing
This research American Journal of Gastroenterology January 6th.
Previous studies have identified numerous genetic variants and several modifiable risk factors for IBD, but data on the combined effects of genetics and lifestyle are limited, the study authors wrote. I’m here.
Li and colleagues conducted a UK Biobank-based prospective cohort study to examine associations between genetic risk, modifiable lifestyle factors, and IBD risk. They analyzed data from her 453,492 participants recruited between 2006 and 2010. However, non-European ancestry, individuals with no genetic information, new-onset IBD, or individuals with unknown IBD diagnosis were excluded.
The research team used common genetic variants that were strongly associated with IBD in previous genome-wide association meta-analyses to estimate genetic susceptibility to Crohn’s disease or ulcerative colitis, using polygenic mutations. Built a risk score. They used 51 independent single nucleotide polymorphisms to calculate a risk score for Crohn’s disease and 30 to calculate a risk score for ulcerative colitis.
They also constructed a genomic risk score by including all single nucleotide polymorphisms reported in genome-wide association studies at suggestive significance levels. The research team then used either the polygenic risk score or the genomic risk score to describe their genetic susceptibility to IBD and divided participants into low, medium, and high genetic risk groups.
For lifestyle, the research team looked at six factors associated with either Crohn’s disease or ulcerative colitis in a recent comprehensive review and cohort study. These factors are smoking, alcohol consumption, obesity, sleep duration, diet, and regular physical activity.
The researchers then developed a healthy lifestyle score, showing that higher lifestyle scores indicate higher adherence to a healthy lifestyle. 4 or 5 healthy lifestyle factors), intermediate (3 factors), or unfavorable (0 to 2 factors). The research team then created a weighted score and adjusted for age, gender, education, and other variables. These scores were also classified as favorable, intermediate, or unfavorable.
Overall, 707 Crohn’s disease patients and 1576 ulcerative colitis patients were diagnosed during a median follow-up of 12 years. The median age of diagnosis was 65 for Crohn’s disease and 66 for ulcerative colitis, both from his 43 to his 82.
For genetic susceptibility, both polygenic and genomic risk scores showed significant associations with the risk of Crohn’s disease and ulcerative colitis. The risk of IBD increased linearly across genetic risk categories (low to high). Compared with participants at low genetic risk, participants at high genetic risk had a hazard ratio of 2.24 for Crohn’s disease and 2.15 for ulcerative colitis.
In general, the lower the healthy lifestyle score, the higher the risk of IBD. With the exception of alcohol consumption, all lifestyle factors were associated with increased risk of both Crohn’s disease and ulcerative colitis.
Furthermore, having a healthier lifestyle was significantly associated with lower risk of Crohn’s disease and ulcerative colitis in a dose-response manner. participants had a hazard ratio of 1.94 for Crohn’s disease and 1.98 for ulcerative colitis. His cumulative incidence of IBD during follow-up was higher in the unfavorable lifestyle group.
Genetics – Lifestyle Connections
A joint analysis of genetic risk and healthy lifestyle showed that the hazard ratios for both Crohn’s disease and ulcerative colitis increased proportionally with increasing genetic risk and decreasing healthy lifestyle. I was.
Compared with participants with low genetic risk and favorable lifestyle, participants with high genetic risk and unfavorable lifestyle had a hazard ratio of 4.4 for Crohn’s disease and 4.44 for ulcerative colitis. bottom. There was no significant difference in hazard ratios between the high genetic risk but favorable lifestyle group and the low genetic risk but unfavorable lifestyle group.
Across all genetic groups, participants with unfavorable lifestyles were at increased risk of IBD. For example, among those at low genetic risk, those with poor lifestyles had a 2.32 hazard ratio for Crohn’s disease and a 1.7 hazard ratio for ulcerative colitis compared with those with favorable lifestyles.
Calculating the cumulative risk of IBD over 12 years, those with high genetic risk and poor lifestyle had a 4.88-fold higher risk of Crohn’s disease than those with low genetic risk and good lifestyle, The risk of ulcerative colitis was 5.28 times higher. Lifestyle.
“IBD was once thought to be primarily a genetic disease, but based on multiple studies over the years, we know that IBD and lifestyle/environmental links play a bigger role. said Miguel Regueiro, MD, Chair of Digestive, Institute of Disease and Surgery, Cleveland Clinic, Ohio. Medscape Medical News.
Regueiro, who was not involved in this study, is studying the natural history of IBD and postoperative prevention of Crohn’s disease.
Examples of healthy lifestyles
Li and colleagues noted the important clinical implications of promoting a healthy lifestyle as an effective strategy to reduce the incidence of IBD, even among people with high-risk genetic backgrounds. I’m here.
Legueiro said the study can’t definitively link lifestyle to causation, but the results “further support a healthy lifestyle.” If you have a strong family history or high genetic risk, it’s even more important to eat healthy and lead a healthy lifestyle.
Given the study’s focus on the middle-aged and older population, future studies should investigate the impact of lifestyle factors by age, the study’s authors wrote. Studies need to include frequently repeated assessments of lifestyle factors to understand the effects of varying lengths of unhealthy lifestyles, they write.
The Cleveland Clinic has created an IBD Medical Home with a focus on creating a healthy lifestyle, eating healthy and reducing stress.
“We are studying the impact of medical facilities and lifestyle on IBD,” he said. “As I tell all his IBD sufferers and her IBD sufferer family members, a healthy lifestyle not only helps prevent cardiovascular disease, but perhaps he also prevents IBD.”
J digestive system. Published online on January 6, 2023. https://doi.org/10.14309/ajg.0000000000002180.
This research was supported by the National Science Fund for Distinguished Young Researchers of Zhejiang Province, the National Natural Science Foundation of China, the Hunan Major R&D Program, the Swedish Heart and Lung Foundation, the Swedish Research Council, the Swedish Cancer Society, and CRUK Career. Development Fellowship. The author and Legueiro have declared no relevant financial relationships.
Carolyn Crist is a health and medical journalist reporting on the latest research for Medscape, MDedge and WebMD.
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