Andrea Tenca1, Martti Färkkilä, Hannu Jalanko, Katariina Vapalahti, Johanna Arola, Tytti Jaakkola, Roberto Penagini, Olli Vapalahti, Kaija-Leena Kolho. 1. *Clinic of Gastroenterology †Department of Pediatric Nephrology and Transplantation, University of Helsinki and Helsinki University Hospital ‡University of Helsinki §Department of Pathology, University of Helsinki and Helsinki University Hospital ||Department of Pediatric Gastroenterology, University of Helsinki and Children's Hospital, Helsinki, Finland ¶Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy #Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Abstract
OBJECTIVES: The aim of this population-based observational case-control questionnaire study was to investigate the possible role of environmental risk factors associated with pediatric-onset autoimmune liver diseases. METHODS: Seventy-one patients with autoimmune liver diseases (<16 years) received a questionnaire with 22 items, evaluating contact with environmental factors (eg, family manners, type of housing, pets) before the diagnosis. Two age- and sex-matched control groups were used: inflammatory bowel disease (IBD; n = 91) and healthy subjects (n = 716; matched also for place of residence at birth). Univariate analysis (odds ratio [OR] and 95% confidence interval) for all variables was calculated. Fisher exact test was performed to depict associations between variables and the multivariate logistic regression to test their interactions. RESULTS: In the final analyses, the responses of 51 autoimmune liver diseases cases (n = 51/71, 72%), 59 IBD controls (n = 59/91, 65%), and 292 healthy controls (n = 292/716, 41%) were investigated. In univariate analysis only having a cat, a dog, and a cat or a dog were risk factors of autoimmune liver diseases (OR varying between 2.6-3.4); no other significant associations (eg, place of residence, number of siblings, family manners) were found. Multivariate logistic regression analyses showed that especially living with a cat in block of flats was a risk factor (OR 3.6, 1.2-10.8). CONCLUSIONS: Living in a close contact with a pet (especially a cat) was a risk factor of autoimmune liver diseases. This finding may suggest an involvement of an unidentified agent (ie, toxin/microbe) among the triggers of these diseases.
OBJECTIVES: The aim of this population-based observational case-control questionnaire study was to investigate the possible role of environmental risk factors associated with pediatric-onset autoimmune liver diseases. METHODS: Seventy-one patients with autoimmune liver diseases (<16 years) received a questionnaire with 22 items, evaluating contact with environmental factors (eg, family manners, type of housing, pets) before the diagnosis. Two age- and sex-matched control groups were used: inflammatory bowel disease (IBD; n = 91) and healthy subjects (n = 716; matched also for place of residence at birth). Univariate analysis (odds ratio [OR] and 95% confidence interval) for all variables was calculated. Fisher exact test was performed to depict associations between variables and the multivariate logistic regression to test their interactions. RESULTS: In the final analyses, the responses of 51 autoimmune liver diseases cases (n = 51/71, 72%), 59 IBD controls (n = 59/91, 65%), and 292 healthy controls (n = 292/716, 41%) were investigated. In univariate analysis only having a cat, a dog, and a cat or a dog were risk factors of autoimmune liver diseases (OR varying between 2.6-3.4); no other significant associations (eg, place of residence, number of siblings, family manners) were found. Multivariate logistic regression analyses showed that especially living with a cat in block of flats was a risk factor (OR 3.6, 1.2-10.8). CONCLUSIONS: Living in a close contact with a pet (especially a cat) was a risk factor of autoimmune liver diseases. This finding may suggest an involvement of an unidentified agent (ie, toxin/microbe) among the triggers of these diseases.
Authors: Mercedes Martinez; Emily R Perito; Pamela Valentino; Cara L Mack; Madeleine Aumar; Annemarie Broderick; Laura G Draijer; Eleonora D T Fagundes; Katryn N Furuya; Nitika Gupta; Simon Horslen; Maureen M Jonas; Binita M Kamath; Nanda Kerkar; Kyung Mo Kim; Kaija-Leena Kolho; Bart G P Koot; Trevor J Laborda; Christine K Lee; Kathleen M Loomes; Tamir Miloh; Douglas Mogul; Saeed Mohammed; Nadia Ovchinsky; Girish Rao; Amanda Ricciuto; Alexandre Rodrigues Ferreira; Kathleen B Schwarz; Vratislav Smolka; Atsushi Tanaka; Mary E M Tessier; Venna L Venkat; Bernadette E Vitola; Marek Woynarowski; Melissa Zerofsky; Mark R Deneau Journal: Hepatology Date: 2021-09-09 Impact factor: 17.298