Jing H Ngu1,2, Richard B Gearry3,4, Chris M Frampton5, Catherine A M Stedman6,7. 1. University of Otago, Christchurch, Canterbury, New Zealand. jeffrey.ngu@cdhb.health.nz. 2. Department of Gastroenterology, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. jeffrey.ngu@cdhb.health.nz. 3. University of Otago, Christchurch, Canterbury, New Zealand. richard.gearry@cdhb.health.nz. 4. Department of Gastroenterology, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. richard.gearry@cdhb.health.nz. 5. University of Otago, Christchurch, Canterbury, New Zealand. chris.frampton@otago.ac.nz. 6. University of Otago, Christchurch, Canterbury, New Zealand. catherine.stedman@cdhb.health.nz. 7. Department of Gastroenterology, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand. catherine.stedman@cdhb.health.nz.
Abstract
PURPOSE: The etiology of autoimmune hepatitis (AIH) likely involves a complex interaction of genetic and environmental factors. We aim to investigate the associations between exposure to putative environmental factors and AIH and to quantify AIH risk in a first-degree relative. METHODS: We conducted a population-based case-control study. Cases were AIH patients who were alive and resided in Canterbury, New Zealand, between 1 July 2011 and 30 June 2012. Controls were randomly selected from the Electoral Roll and were matched 2:1 to each case by age and gender. Self-reporting questionnaires that cover lifestyle factors, childhood factors and family history were used. RESULTS: 72 AIH cases and 144 controls were included. We found that exposure to antibiotics within 12 months prior to AIH diagnosis (OR 12.98, 95 % CI 2.49-67.67, p < 0.01) was an independent risk factor for the development of AIH. Alcohol consumption (OR 0.43, 95 % CI 0.28-0.68, p < 0.01) and childhood home with wood heating (OR 0.30, 95 % CI 0.14-0.63, p < 0.01) were independently associated with reduced risks of later development of AIH. The crude risk of AIH in first-degree relatives of a patient with AIH was 0.2 % (95 % CI <0.1-2.0). CONCLUSIONS: We found that antibiotics are an independent risk factor for the development of AIH, whereas alcohol consumption and living in a childhood home with wood heating are independent protective factors against the later development of AIH.
PURPOSE: The etiology of autoimmune hepatitis (AIH) likely involves a complex interaction of genetic and environmental factors. We aim to investigate the associations between exposure to putative environmental factors and AIH and to quantify AIH risk in a first-degree relative. METHODS: We conducted a population-based case-control study. Cases were AIH patients who were alive and resided in Canterbury, New Zealand, between 1 July 2011 and 30 June 2012. Controls were randomly selected from the Electoral Roll and were matched 2:1 to each case by age and gender. Self-reporting questionnaires that cover lifestyle factors, childhood factors and family history were used. RESULTS: 72 AIH cases and 144 controls were included. We found that exposure to antibiotics within 12 months prior to AIH diagnosis (OR 12.98, 95 % CI 2.49-67.67, p < 0.01) was an independent risk factor for the development of AIH. Alcohol consumption (OR 0.43, 95 % CI 0.28-0.68, p < 0.01) and childhood home with wood heating (OR 0.30, 95 % CI 0.14-0.63, p < 0.01) were independently associated with reduced risks of later development of AIH. The crude risk of AIH in first-degree relatives of a patient with AIH was 0.2 % (95 % CI <0.1-2.0). CONCLUSIONS: We found that antibiotics are an independent risk factor for the development of AIH, whereas alcohol consumption and living in a childhood home with wood heating are independent protective factors against the later development of AIH.
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