Brief Article
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World J Gastroenterol. Mar 21, 2013; 19(11): 1827-1833
Published online Mar 21, 2013. doi: 10.3748/wjg.v19.i11.1827
Multicenter case-control study of the risk factors for ulcerative colitis in China
Yu-Fang Wang, Qin Ou-yang, Bing Xia, Li-Na Liu, Fang Gu, Kai-Fang Zhou, Qiao Mei, Rui-Hua Shi, Zhi-Hua Ran, Xiao-Di Wang, Pin-Jin Hu, Kai-Chun Wu, Xin-Guang Liu, Ying-Lei Miao, Ying Han, Xiao-Ping Wu, Guo-Bing He, Jie Zhong, Guan-Jian Liu
Yu-Fang Wang, Qin Ou-yang, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Bing Xia, Department of Gastroenterology, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan 430071, Hubei Province, China
Li-Na Liu, Department of Gastroenterology, First Affiliated Hospital of Dalian Medical University, Dalian 116021, Liaoning Province, China
Fang Gu, Department of Gastroenterology, Third Hospital of Beijing University, Beijing 100191, China
Kai-Fang Zhou, Department of Gastroenterology, Union Hospital Tongji Medical College, Huazhong Science and Technology University, Wuhan 430074, Hubei Province, China
Qiao Mei, Department of Gastroenterology, First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Rui-Hua Shi, Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Zhi-Hua Ran, Department of Gastroenterology, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai 200127, China
Xiao-Di Wang, Department of Gastroenterology, Beijing Sino-Japan Friendship Hospital, Beijing 10029, China
Pin-Jin Hu, Department of Gastroenterology, First Affiliated Hospital, Zhongshan Medical University, Guangzhou 528000, Guangdong Province, China
Kai-Chun Wu, State Key Laboratory of Cancer Biology and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Xin-Guang Liu, Department of Gastroenterology, First Affiliated Hospital, Peking University, Beijing 100034, China
Ying-Lei Miao, Department of Gastroenterology, First Affiliated Hospital of Kunming Medical College, Kunming 650032, Yunnan Province, China
Ying Han, Department of Gastroenterology, the Military General Hospital of Beijing PLA, Beijing 10026, China
Xiao-Ping Wu, Department of Gastroenterology, Xiangya Hospital, Second Affiliated Hospital of Zhongnan University, Changsha 410008, Hunan Province, China
Guo-Bing He, Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanyun 637000, Sichuan Province, China
Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University, Shanghai 200025, China
Guan-Jian Liu, Department of Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: All these authors contributed equally to this paper; all authors designed the questionnaire and performed the investigation; Wang YF and Ou-yang Q designed the study and wrote the manuscript; Liu GJ analyzed the data.
Correspondence to: Qin Ou-yang, Professor, Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. qin.ouyang@163.com
Telephone: +86-28-85422387 Fax: +86-28-85423387
Received: October 24, 2012
Revised: December 28, 2012
Accepted: January 17, 2013
Published online: March 21, 2013
Processing time: 149 Days and 11.7 Hours
Abstract

AIM: To evaluate potential risk factors in the development of ulcerative colitis (UC) in China.

METHODS: A total of 1308 patients with UC and 1308 age-matched and sex-matched controls were prospectively studied in China. The UC cases were collected from 17 hospitals in China from April 2007 to April 2010. Uniform questionnaires were designed to investigate risk factors including smoking, appendectomy, stress, socio-economic conditions, nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, diet, breastfeeding, infections and family sanitary conditions. Group comparisons by each factor were done using simple logistic regression analysis. Conditional logistic regression was used for multivariate analysis.

RESULTS: By univariate analysis, the variables predictive of UC included feeling stress, light and heavy alcoholic drinking, spicy food, sugar consumption and infectious diarrhea, while heavy tea intake and tap water consumption were protective against UC. On multivariate analysis, the protective factor for UC was tap water consumption [odds ratios (OR) = 0.424, 95%CI: 0.302-0.594, P < 0.001]; while the potential risk factors for UC were heavy sugar consumption (OR = 1.632, 95%CI: 1.156-2.305, P < 0.001), spicy food (light intake: OR = 3.329, 95%CI: 2.282-4.857, P < 0.001; heavy intake: OR = 3.979, 95%CI: 2.700-5.863, P < 0.001), and often feeling stress (OR = 1.981, 95%CI: 1.447-2.711, P < 0.001). Other factors, such as smoking habit, appendectomy, breastfeeding, a history of measles, rural or urban residence, education, oral contraceptives, and NSAID use have not been found to have a significant association with the development of UC in the present study.

CONCLUSION: Our study showed tap water consumption was a protective factor for UC, while spicy food, heavy sugar consumption and often feeling stress were risk factors for UC in this Chinese population.

Keywords: Ulcerative colitis; Risk factors; Case-control study