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1 72 Chin J Gastroenterol2015Vol. 20No. 2 * # UC UC UC UC 103 UC NSAIDs P < Logistic NSAIDs UC P < UC P < UC NSAIDs UC Study on Hygiene Hypothesis and Other Related Factors of Ulcerative Colitis YUAN ShaWANG QiaominSONG JizhongWU ZhengxiangXIE LiL ChaolanWANG Chao. Department of GastroenterologyAnhui Provincial Hospital Affiliated to Anhui Medical UniversityHefei Correspondence to WANG Qiaomin wqmin928@ 163. com Background The incidence of ulcerative colitis UC is increasing over the past two decades in China. Environmental factorssuch as childhood hygiene and dietary factors were found to be implicated in the etiology of UC in recent studies. Aims To investigate the possible pathogenic factors of UC. Methods A hospital-based case-control study matched 1 1 on gender and age was carried out in Anhui Provincial Hospital. A total of 103 UC cases and 103 control subjects were recruited to fulfill a questionnaire survey. Information on childhood hygienebreastfeedingpassive smoking daily diet prior to UCpast medical history and other related factors were collected. Univariate and multivariate analysis were performed to screen the factors related with UC. Results In univariate analysisnumber of siblings in the family childhood life including contacting animalsdrinking raw waterand consumption of unwashed fruits /vegetablesdaily dietary factors including consumption of whole grainssweets and fried foodeating habitsand use of non-steroidal antiinflammatory drugs NSAIDs and antibiotics were significantly different between UC group and control group P < Multivariate conditional Logistic regression analysis revealed that frequent consumption of fried food in daily life and frequent use of NSAIDs and antibiotics were risk factors for UC P < whereas frequent consumption of unwashed fruits / vegetables in childhood and frequent consumption of whole grains in daily life were protective factors for UC P < Conclusions Highly hygienic living conditions in childhood may increase the risk of UC. Fewer fried foodsuitable whole grains and fair use of NSAIDs and antibiotics might protect against the occurrence of UC. Key words ColitisUlcerative Risk Factors Hygiene Hypothesis Environmental Factors Case-Control Studies ulcerative colitisuc DOI /j. issn * @ qq. com # wqmin928@ 163. com Crohn s diseasecd inflammatory bowel disease IBD UC 20

2 UC / / / / UC /3 ~ 4 // 2 < 100 g /250 g / > 500 g 3 UC 2 /3 ~ 6 / 7 4 IBD / / 3 / / UC 3 ~ 4 // 7 UC / 8 / / UC // 瑏瑤 /< 2 // // UC IBD UC / / UC / < 20 m 2 /20 ~ 40 m 2 / > 40 m 瑏瑡 / / 瑏瑢 SPSS 瑏瑣 / / 瑏瑤 / χ 2 / 瑏瑥 3 / > 3 / 瑏瑦 9 / / 10 / / 3 / 1 瑏瑡 / / 瑏瑢 /< 10 // 10 // 瑏瑣 /< 2 // UC 76. 3% 750 t Wilcoxon P < / Logistic P < 0. 05

3 74 Chin J Gastroenterol2015Vol. 20No. 2 OR 95% CI Logistic = 2 Cox = 1 = 2 = 1 = 2 = 0 = 1 = 0 = 1 = 2 / = 3 / = 4 = 5 = 1 = ~ 75 < 20 m 2 = 1 20 ~ 40 m 2 = 2> 40 m 2 = 3 / 1 = 1 2 = 2 3 = 3> 3 = = 0 = 1 = 2 3 = 1> 3 = 2 = 3 = 1 3 ~ 4 /= 2 = 3 < 100 g = g = 2> 500 g = 3 2 = 1 3 ~ 6 = 2 7 = 3 = 0 3 ~ 4 /= 1 = 2 = 1 = 2 = 3 = 0 = 1 P < = 2 = 0 = 1 = 2 / / = 0 = 1 = 2 = 3 / = 0= 1 P < / / = 0 = ± ~ ± ± P = NSAIDs 1 1 UC n = 103 n = 103 P / 62 /41 62 /41 χ 2 = x 珋 ± s ± ± t = / 7 /96 10 /93 χ 2 = * 9 /10 /42 /21 /19 /2 2 /10 /44 /14 /30 /3 Z = / 81 /22 88 /15 χ 2 = /28 /34 /7 /4 /0 25 /33 /27 /13 /4 /1 Z = /29 /23 /1 /1 /0 50 /27 /20 /4 /2 /0 Z = / 66 /37 68 /35 χ 2 = < 20 m 2 /20 ~ 40 m 2 / > 40 m 2 38 /39 /26 57 /19 /27 Z = /2 /3 / > 3 5 /34 /18 /46 4 /13 /33 /53 Z = /2 /3 / > 3 29 /39 /18 /17 29 /32 /22 /20 Z = / 19 /84 23 /80 χ 2 = / 14 /89 11 /92 χ 2 = / 95 /8 91 /12 χ 2 = / 29 /74 23 /80 χ 2 = / 65 /38 45 /58 χ 2 = / / 12 /57 /34 8 /44 /51 Z = / 53 /50 43 /60 χ 2 = / / 5 /80 /18 19 /67 /17 Z = / / 27 /63 /13 18 /53 /32 Z = / > 3 / 8 /46 /49 15 /29 /59 Z = / 31 /72 29 /74 χ 2 = /3 ~ 4 // 73 /19 /11 44 /35 /24 Z =

4 n = 103 n = 103 P < 100 g /250 g / > 500 g 38 /60 /5 31 /58 /14 Z = /3 ~ 6 / 7 77 /20 /6 72 /25 /6 Z = / / 1 /76 /26 6 /80 /17 Z = / 66 /37 69 /34 χ 2 = /3 ~ 4 // 84 /10 /9 90 /10 /3 Z = / 11 /68 /24 3 /77 /23 Z = / / 8 /55 /40 9 /50 /44 Z = / / 5 /70 /28 15 /79 /9 Z = / / 9 /50 /44 7 /53 /43 Z = / / 14 /51 /38 13 /76 /14 Z = / / / 59 /15 /17 /12 61 /12 /25 /5 Z = / / / 42 /29 /29 /3 42 /33 /26 /2 Z = / / / 24 /40 /39 /0 17 /48 /38 /0 Z = / 55 /48 46 /57 χ 2 = / 98 /5 92 /11 χ 2 = / 97 /6 100 /3 χ 2 = NSAIDs / 83 /20 93 /10 χ 2 = / 101 /2 96 /7 χ 2 = / 103 /0 101 /2 χ 2 = / 75 /28 94 /9 χ 2 = * / / / / / 10 Logistic NSAIDs UC 5 UC UC 2 NSAIDs 2 UC Logistic B S. E. Wald P OR 95% CI ~ ~ ~ NSAIDs ~ ~

5 76 Chin J Gastroenterol2015Vol. 20No. 2 UC UC hygiene hypothesis sis NF- κb 8 2 IBD Rook old friend hypothe- UC T Treg UC APCreg 3 UC UC UC UC IBD UC 3-6 UC UC UC UC UC 12 > 120 UC 7 UC 11 UC DNA 10 IBD UC 8 UC Shaw 13 UC 2 ~ 5 3 UC NSAIDs UC UC UC UC NSAIDs UC

6 Chu KMWatermeyer GShelly L et al. Childhood helminth exposure is protective against inflammatory bowel disease a case control study in South Africa J. Inflamm Bowel Dis Elliott DEWeinstock JV. Where are we on worms J. APC T T Curr Opin Gastroenterol Hansen TS Jess TVind Iet al. Environmental factors in 12 inflammatory bowel disease a case-control study based on 9 a Danish inception cohortj. J Crohns Colitis20115 NSAIDs UC NF-κB -2 COX-2 J COX PG 10. J Ananthakrishnan ANKhalili HKonijeti GGet al. A prospective study of long-term intake of dietary fiber and NSAIDs UC risk of Crohn s disease and ulcerative colitis J. Gastroenterology UC UC 12. J. UC Shaw SYBlanchard JFBernstein CN. Association between NSAIDs UC the use of antibiotics and new diagnoses of Crohn s disease and ulcerative colitis J. Am J Gastroenterol UC 14 Ananthakrishnan ANHiguchi LMHuang ESet al. Aspirinnonsteroidal anti-inflammatory drug useand risk for Crohn disease and ulcerative colitis a cohort study J. Ann Intern Med Felder JBKorelitz BIRajapakse Ret al. Effects of 2012 J. nonsteroidal antiinflammatory drugs on inflammatory bowel Strachan DP. Hay feverhygieneand household size J. BMJ Klement ELysy JHoshen Met al. Childhood hygiene is associated with the risk for inflammatory bowel disease a population-based studyj. Am J Gastroenterol López-Serrano PPérez-Calle JLPérez-Fernández MTet al. Environmental risk factors in inflammatory bowel diseases. Investigating the hygiene hypothesis a Spanish case-control studyj. Scand J Gastroenterol Boneberger AWeiss EHCalvo Met al. Environmental factors in infancy and ulcerative colitis in the Central South of Chile a case-control study J. J Crohns Colitis2011 disease a case-control studyj. Am J Gastroenterol Foster AJacobson K. Changing incidence of inflammatory bowel disease environmental influences and lessons learnt from the South asian population J. Front Pediatr Frolkis ADieleman LABarkema HWet al Alberta IBD Consortium. Environment and the inflammatory bowel diseases J. Can J Gastroenterol e18-e Feagins LACryer BL. Do non-steroidal anti-inflammatory drugs cause exacerbations of inflammatory bowel disease J. Dig Dis Sci

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