SNFGE SNFGE
 
Thématique :
- MICI
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Vered ABITBOL-SELINGER
Coup de coeur :
 
 
The American Journal of Gastroenterology
  2017/09  
 
  2017 Sep;112(9):1412-1422.  
  doi: 10.1038/ajg.2017.208.  
 
  Rural and Urban Residence During Early Life Is Associated with Risk of Inflammatory Bowel Disease: A Population-Based Inception and Birth Cohort Study  
 
  Benchimol EI, Kaplan GG, Otley AR, Nguyen GC, Underwood FE, Guttmann A, Jones JL, Potter BK, Catley CA, Nugent ZJ, Cui Y, Tanyingoh D, Mojaverian N, Bitton A, Carroll MW, deBruyn J, Dummer TJB, El-Matary W, Griffiths AM, Jacobson K, Kuenzig ME, Leddin D, Lix LM, Mack DR, Murthy SK, Sánchez JNP, Singh H, Targownik LE, Vutcovici M, Bernstein CN  
  https://www.ncbi.nlm.nih.gov/pubmed/28741616  
 
 

Abstract

OBJECTIVES:

To determine the association between inflammatory bowel disease (IBD) and rural/urban household at the time of diagnosis, or within the first 5 years (y) of life.

METHODS:

Population-based cohorts of residents of four Canadian provinces were created using health administrative data. Rural/urban status was derived from postal codes based on population density and distance to metropolitan areas. Validated algorithms identified all incident IBD cases from administrative data (Alberta: 1999-2008, Manitoba and Ontario: 1999-2010, and Nova Scotia: 2000-2008). We determined sex-standardized incidence (per 100,000 patient-years) and incident rate ratios (IRR) using Poisson regression. A birth cohort was created of children in whom full administrative data were available from birth (Alberta 1996-2010, Manitoba 1988-2010, and Ontario 1991-2010). IRR was calculated for residents who lived continuously in rural/urban households during each of the first 5 years of life.

RESULTS:

There were 6,662 rural residents and 38,905 urban residents with IBD. Incidence of IBD per 100,000 was 33.16 (95% CI 27.24-39.08) in urban residents, and 30.72 (95% CI 23.81-37.64) in rural residents (IRR 0.90, 95% CI 0.81-0.99). The protective association was strongest in children <10 years (IRR 0.58, 95% CI 0.43-0.73) and 10-17.9 years (IRR 0.72, 95% CI 0.64-0.81). In the birth cohort, comprising 331 rural and 2,302 urban residents, rurality in the first 1-5 years of life was associated with lower risk of IBD (IRR 0.75-0.78).

CONCLUSIONS:

People living in rural households had lower risk of developing IBD. This association is strongest in young children and adolescents, and in children exposed to the rural environment early in life.

 
 
Question posée
 
L’incidence des MICI est-elle modifiée par la résidence en zone rurale ou urbaine ?
 
Question posée
 
Oui. La résidence en zone rurale est associée à une diminution du risque de MICI. Cette association est plus forte chez les jeunes enfants et adolescents surtout s’ils ont vécu en zone rurale dans les 5 premières années de vie
 
Commentaires

Large étude basée sur les données administratives de 4 provinces canadiennes montrant le rôle de l’environnement dans la physiopathologie des MICI.

 
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