SNFGE SNFGE
 
Thématique :
- Colo-proctologie
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Docteur Pauline JOUET
Coup de coeur :
 
 
Gastroenterology
  2018/12  
 
  2018 Dec;155(6):1764-1775.e2.  
  doi: 10.1053/j.gastro.2018.08.029.  
 
  Identification of Menopausal and Reproductive Risk Factors for Microscopic Colitis-Results From the Nurses' Health Study.  
 
  Burke KE, Ananthakrishnan AN, Lochhead P, Liu PH, Olen O, Ludvigsson JF, Richter JM, Tworoger SS, Chan AT, Khalili H  
  https://www.ncbi.nlm.nih.gov/pubmed/30144433  
 
 

Abstract

BACKGROUND & AIMS:

Microscopic colitis is a chronic inflammatory disorder of the colon primarily affecting postmenopausal women. However, the relation between hormonal determinants, including reproductive and menopausal factors, and risk of microscopic colitis has yet to be characterized.

METHODS:

We collected data from 227,766 women who participated in the Nurses' Health Study (NHS) and the NHSII without a baseline history of microscopic colitis. Reproductive and menopausal factors were assessed in 1988 in the NHS and 1989 in the NHSII and updated biennially. Cases of microscopic colitis were confirmed through review of pathology records. We used Cox proportional hazards modeling to estimate hazard ratios and 95% confidence intervals.

RESULTS:

Through 2014 in the NHS and 2015 in the NHSII, we confirmed 275 incident cases of microscopic colitis over 5,147,282 person-years. Compared with never use, current use of menopausal hormone therapy was associated with increased risk of microscopic colitis (multivariable-adjusted hazard ratio 2.64; 95% confidence interval 1.78-3.90). The risk increased with longer duration of use (P for trend < .0001) and decreased after discontinuation (P for trend = .002). The association did not differ according to disease subtype (P for heterogeneity = .34). Similarly, ever use of oral contraceptives was associated with increased risk of microscopic colitis (multivariable-adjusted hazard ratio 1.57; 95% confidence interval 1.16-2.13). There were no associations between age at menarche, parity, age at first birth, age at menopause, or menopause type and incident microscopic colitis.

CONCLUSIONS:

In 2 large prospective cohort studies, we observed an association between exogenous hormone use and incident microscopic colitis. Further studies are needed to determine the mechanisms underlying these associations.

 

 
Question posée
 
Existe-t-il une association entre la prise de traitement hormonal et l’apparition d’une colite microscopique ?
 
Question posée
 
Dans cette étude portant sur 227,766 infirmières américaines, le risque de colite microscopique était significativement augmenté en cas de prise d’un traitement hormonal substitutif (HR 2.64; 95% CI 1.78-3.90, P <0,0001), et à un moindre niveau en cas de prise d’une contraception orale (HR1.57; 95% CI 1.16-2.13).
 
Commentaires

Une association entre traitement hormonal et colite microscopique qui ne permet pas d’affirmer avec certitude que le traitement en est la cause mais qui suggère un effet possible des hormones sur la barrière épithéliale.

 
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