Antibiotic use as a risk factor for inflammatory bowel disease across the ages: a population-based cohort study

Gut, Journal Year: 2023, Volume and Issue: 72(4), P. 663 - 670

Published: Jan. 9, 2023

Background There is an increasing incidence of inflammatory bowel disease (IBD) for which environmental factors are suspected. Antibiotics have been associated with development IBD in earlier generations, but their influence on risk adults uncertain. Objective To assess the impact antibiotic exposure, including dose–response, timing and class, all individuals aged ≥10 years. Design Using Denmark nationwide registries, a population-based cohort residents years was established between 2000 2018. Incidence rate ratios (IRRs) following exposure were calculated using Poisson regression. Results total 6 104 245 individuals, resulting 87 112 328 person-years follow-up, 52 898 new cases IBD. Antibiotic increased as compared no age groups, although greatest among 40–60 ≥60 (age 10–40 years, IRR 1.28, 95% CI 1.25 to 1.32; 1.48, 1.43 1.54; 1.47, 1.42 1.53). For groups positive dose–response observed, similar results seen both ulcerative colitis Crohn’s disease. The highest developing 1–2 after use classes often prescribed treat gastrointestinal pathogens. Conclusion IBD, 40 older. This cumulative antibiotics targeting pathogens within exposure.

Language: Английский

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Anthropometric Trajectories in Children Prior to Development of Inflammatory Bowel Disease

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(1), P. e2455158 - e2455158

Published: Jan. 17, 2025

Importance Poor nutrition and growth in childhood have short-term long-term consequences, so understanding the timing of onset an impaired nutritional status is crucial for diagnosing treating inflammatory bowel disease (IBD) at its earliest stage. Objective To assess anthropometric trajectories before a pediatric diagnosis IBD recovery after diagnosis. Design, Setting, Participants This population-based cohort study included children born Denmark from January 1, 1997, through December 31, 2015, with weight length or height measurements birth least 1 measurement school age based on Danish Medical Birth Register National Child Health Register. Within this population, all individuals diagnosed ages 5 to 17 years, according Patient Register, were identified. Data analyzed October 13, 2023, April 17, 2024. Exposure A compared corresponding population without disease. Main Outcomes Measures The outcome measures z scores height, weight, body mass index (BMI [calculated as kilograms divided by meters squared]) reference sibling populations. Results final 916 133 (51.2% male) median 3 pairs collected (IQR, 2-6 pairs). Of those, 1522 (median age, 14.3 years [IQR, 11.8-16.3 years]; 763 female [50.1%]) (851 [55.9%] Crohn [CD] 671 [44.1%] ulcerative colitis [UC]). Compared IBD, later CD had declining (weight: mean, −0.12 g [95% CI, −0.20 −0.03 g]; BMI: −0.13 −0.21 −0.04]) year (length height: cm −0.29 −0.10 cm]) prior diagnosis, whereas was observed UC (mean, −0.22 −0.02 g]) BMI −0.23 −0.03]). Deviating patterns persisted slowest CD. Conclusions Relevance findings large-scale anthropometrics suggest assessed up UC. These emphasize that may occur first treatment, frequent screenings help ensure healthy transition adulthood.

Language: Английский

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Familial confounding in the associations between maternal health and autism

Nature Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 31, 2025

Evidence suggests that maternal health in pregnancy is associated with autism the offspring. However, most diagnoses pregnant women have not been examined, and role of familial confounding remains unknown. Our cohort included all children born Denmark between 1998 2015 (n = 1,131,899) their parents. We fitted Cox proportional hazard regression models to estimate likelihood each prenatal ICD-10 diagnosis, accounting for disease chronicity comorbidity, correlations sociodemographic factors. examined evidence using discordant sibling paternal negative control designs. Among 1,131,899 individuals our sample, 18,374 (1.6%) were diagnosed by end follow-up. Across 236 we tested (prevalence ≥0.1%), 30 significantly after factors, disorder correction multiple testing. This obstetric, cardiometabolic psychiatric disorders (for example, diabetes (hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.08-1.31) depression (HR 1.49, CI 1.27-1.75)), previously shown be autism. Family-based analyses provided strong observed associations. findings indicate pervasive associations offspring underscore these are largely attributable confounding.

Language: Английский

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Longitudinal trajectories of anxiety, depression, and bipolar disorder in inflammatory bowel disease: a population-based cohort study

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 59, P. 101986 - 101986

Published: May 1, 2023

BackgroundInflammatory bowel disease (IBD) is associated with psychiatric diseases, but it unclear to what degree patients IBD are affected over their lifetime. We aimed longitudinally investigate the risk of anxiety, depression, and bipolar disorder before after diagnosis understand full burden these diseases in IBD.MethodsIn this population based cohort study, we identified 22,103 diagnosed between January 1, 2003 December 31, 2013 Danish National registers 110,515 matched reference individuals from general population. calculated yearly prevalence hospital contacts for dispensed prescriptions antidepressants five years ten diagnosis. used logistic regression calculate odds ratios (OR) each outcome prior diagnosis, Cox hazard (HR) new outcomes diagnosis.FindingsDuring >150,000 person follow-up, had higher anxiety (OR 1.4; 95% confidence interval (CI) 1.2–1.7) depression CI 1.3–1.6) starting at least continuing until (HR 1.3; 1.1–1.5 HR 1.5; 1.4–1.7 depression). The was particularly high around age 40 years. found no association disorder.InterpretationThis population-based study suggests that clinically significant comorbidities both which warrant thorough evaluation management, time diagnosis.FundingThe Research Foundation [DNRF148], Lundbeck [R313-2019-857], Aage og Johanne Louis-Hansens Fond [9688-3374 TJS].

Language: Английский

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Has the Incidence of Inflammatory Bowel Disease Peaked? Evidence From the Population-Based NorDIBD Cohort 1978–2020

The American Journal of Gastroenterology, Journal Year: 2023, Volume and Issue: 118(3), P. 501 - 510

Published: Jan. 13, 2023

While the incidence of inflammatory bowel disease (IBD) is rising globally, it has been suggested to stabilize in westernized countries, but this not yet shown exhaustive and large cohorts. We generated an IBD cohort North Denmark (NorDIBD) 6,158 patients with diagnosed from 1978 2020, based on all recorded verified diagnoses region. describing establishment cohort, we aimed present accurate prevalence over 4 decades.The NorDIBD covered pediatric adult diagnosis dated between January 1, 1978, December 31, living Denmark, hence forming unselected population-based patient cohort. rates 2020 point prevalences 2003 were calculated.We observed a 4-fold increase 11.5 per 100,000 persons (95% confidence interval [CI] 8.4-14.6) year 51.3/100,000 CI 45.5-57.1) 2014, whereas rate stabilized. The overall more than doubled 424 407-443) 872 849-896) cases 2020.Our suggests stabilizing continues rise. Because data represent 10% sample entire Danish population, believe that can be extrapolated population general used for healthcare planning.

Language: Английский

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Increased risk of obstructive lung disease in inflammatory bowel disease: A population‐based cohort study

United European Gastroenterology Journal, Journal Year: 2024, Volume and Issue: 12(4), P. 477 - 486

Published: Jan. 6, 2024

Abstract Background and Aims Inflammatory bowel disease (IBD) is associated with manifestations in organs other than the gastrointestinal tract. In this study, we aimed to estimate odds of obstructive lung (OLD) before IBD onset risk OLD after onset. Methods a nationwide population‐based Danish cohort study from 1999 2018, individuals were identified using registries. Between 2003 2013, 24,238 matched 1:10 non‐IBD individuals. Logistic regression was used prevalence ratio for Time‐to‐event analysis performed explore sensitivity analysis, time‐to‐event repeated composite outcome separate outcomes, chronic pulmonary (COPD), asthma, bronchiectasis. Results Individuals 60% more likely have (adjusted ratio: 1.60, 95% confidence interval [CI]: 1.53–1.67). Furthermore, their 40% higher diagnosis hazard [aHR]: 1.43, CI: 1.37–1.49). The increased (aHR: 1.63, 1.53–1.73). Similar results found COPD asthma separately, whereas bronchiectasis 2‐fold 2.44, 1.91–3.11). Conclusion before‐ following an increased. We encourage physicians be vigilant symptoms persons OLD.

Language: Английский

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Safety of Vedolizumab and Ustekinumab Compared With Anti-TNF in Pregnant Women With Inflammatory Bowel Disease

Clinical Gastroenterology and Hepatology, Journal Year: 2024, Volume and Issue: 23(1), P. 144 - 153.e22

Published: Jan. 8, 2024

Language: Английский

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Paediatric‐onset immune‐mediated inflammatory disease is associated with an increased mortality risk—A nationwide study

Alimentary Pharmacology & Therapeutics, Journal Year: 2024, Volume and Issue: 59(12), P. 1551 - 1558

Published: April 10, 2024

Summary Background Paediatric‐onset immune‐mediated inflammatory diseases (pIMID) show more aggressive phenotypes than when diagnosed in adults. However, data on mortality are often extrapolated from adult studies. Aim To estimate the effect of pIMID mortality. Methods In a population‐based cohort study using nationwide Danish healthcare registers, we included all patients with Denmark 1980 to 2018. PIMID were defined as ICD codes indicative autoimmune hepatitis, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, juvenile idiopathic arthritis, lupus erythematosus, or vasculitis registered before age 18 years. All‐cause was outcome; cause‐specific secondary outcome. We used Cox survival analysis hazard ratios (HR), and Aalen rate differences. Results 11,581 individuals 99,665 reference individuals, accounting for 1,371,994 person‐years follow‐up. Median interquartile (IQR) at diagnosis 12.6 (7.9–15.9) During follow‐up, 152 316 died; adjusted HR (aHR) 3.8 (95% confidence interval [CI] 3.1–4.7). This corresponded 6.9 CI: 5.3–8.5) additional deaths per 10,000 person‐years. The strongest associations found gastrointestinal (aHR 22.8; 95% CI 9.6–64.1), cancers 19.2; 5.0–74.2) lymphoproliferative disorders 6.8; 2.8–16.8). Conclusion Patients have fourfold higher risk followed into early adulthood compared individuals. underlines severe disease course highlights need multidisciplinary care.

Language: Английский

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Patients with elderly onset inflammatory bowel disease have a decreased chance of initiation of all types of medications and increased risk of surgeries—A nationwide cohort study

Alimentary Pharmacology & Therapeutics, Journal Year: 2023, Volume and Issue: 58(1), P. 48 - 59

Published: April 20, 2023

Summary Objective In patients with elderly (≥60 years) onset inflammatory bowel disease (IBD), we studied initiation of medications, drug persistency and surgeries. Design A nationwide cohort study based on Danish registries, comprising incident IBD ≥18 years from 1995 to 2020 ( N = 69,039). Patients were divided into 19,187) adult 49,852). Outcomes thiopurines, 5‐ASA, biologics corticosteroids within 1 5 after diagnosis, for those who initiated estimated persistency. Surgeries examined years. We used regression models controlling covariates. Results patients, the adjusted hazard ratios (aHR) initiating 5‐ASA year 0.44 (95% CI 0.42–0.47), 0.77 0.75–0.79) 0.29 0.26–0.31) respectively. The results similar was not impaired aHR stopping steroids 0.80 0.76–0.84) 0.74–0.80) risk surgeries increased in (in ulcerative colitis, years, 1.39 [95% 1.27–1.52], Crohn's 1.13 1.04–1.23]). Conclusion found significantly low chance medications reason may be due mild course. comparable adults. Clinicians should carefully consider whether they underuse IBD‐specific special attention applied timely discontinuation corticosteroids.

Language: Английский

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Characterizing the pre-clinical phase of inflammatory bowel disease

Cell Reports Medicine, Journal Year: 2023, Volume and Issue: 4(11), P. 101263 - 101263

Published: Nov. 1, 2023

Understanding the biological changes that precede a diagnosis of inflammatory bowel disease (IBD) could facilitate pre-emptive interventions, including risk factor modification, but this pre-clinical phase remains poorly characterized. Using measurements from 17 hematological and biochemical parameters taken up to 10 years before in over 20,000 IBD patients population controls, we address at massive scale. We observe widespread significant multiple occur 8 Crohn's (CD) 3 ulcerative colitis. These far exceed previous expectations regarding length pre-diagnostic phase, revealing an opportunity for earlier intervention, especially CD. In summary, using nationwide, case-control dataset—obtained Danish registers—we provide comprehensive characterization IBD.

Language: Английский

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