Kosuke Matsumoto1, Satoko Ohfuji2, Masanori Abe3, Atsumasa Komori4, Atsushi Takahashi5, Hideki Fujii6,7, Kazuhito Kawata8, Hidenao Noritake8, Tomoko Tadokoro9, Akira Honda10, Maiko Asami11, Tadashi Namisaki12, Masayuki Ueno13,14, Ken Sato15, Keisuke Kakisaka16, Mie Arakawa17, Takanori Ito18, Kazunari Tanaka19, Takeshi Matsui19, Toru Setsu20, Masaaki Takamura20, Satoshi Yasuda21, Tomohiro Katsumi22, Jun Itakura23, Tomoya Sano24, Yamato Tamura25, Ryo Miura25, Toshihiko Arizumi25, Yoshinari Asaoka25, Kiyoko Uno26, Ai Nishitani26, Yoshiyuki Ueno22, Shuji Terai20, Yasuhiro Takikawa16, Youichi Morimoto13, Hitoshi Yoshiji12, Satoshi Mochida11, Tadashi Ikegami10, Tsutomu Masaki9, Norifumi Kawada7, Hiromasa Ohira5, Atsushi Tanaka25. 1. Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, Japan. m-kosuke0716@med.teikyo-u.ac.jp. 2. Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan. 3. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan. 4. Clinical Research Center, National Hospital Organization (NHO) Nagasaki Medical Center, Nagasaki, Japan. 5. Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan. 6. Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan. 7. Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan. 8. Hepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Shizuoka, Japan. 9. Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa, Japan. 10. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan. 11. Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Saitama, Japan. 12. Department of Gastroenterology, Nara Medical University, Nara, Japan. 13. Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan. 14. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 15. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan. 16. Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan. 17. Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan. 18. Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan. 19. Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan. 20. Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 21. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan. 22. Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. 23. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan. 24. Division of Gastroenterology, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan. 25. Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, Japan. 26. Teikyo Academic Research Center, Teikyo University, Tokyo, Japan.
Abstract
BACKGROUND: Primary biliary cholangitis (PBC) is considered to be caused by the interaction between genetic background and environmental triggers. Previous case-control studies have indicated the associations of environmental factors (tobacco smoking, a history of urinary tract infection, and hair dye) use with PBC. Therefore, we conducted a multicenter case-control study to identify the environmental factors associated with the development of PBC in Japan. METHODS: From 21 participating centers in Japan, we prospectively enrolled 548 patients with PBC (male/female = 78/470, median age 66), and 548 age- and sex-matched controls. These participants completed a questionnaire comprising 121 items with respect to demographic, anthropometric, socioeconomic features, lifestyle, medical/familial history, and reproductive history in female individuals. The association was determined using conditional multivariate logistic regression analysis. RESULTS: The identified factors were vault toilet at home in childhood [odds ratio (OR), 1.63; 95% confidence interval (CI), 1.01-2.62], unpaved roads around the house in childhood (OR, 1.43; 95% CI, 1.07-1.92), ever smoking (OR, 1.70; 95% CI, 1.28-2.25), and hair dye use (OR, 1.57; 95% CI, 1.15-2.14) in the model for lifestyle factors, and a history of any type of autoimmune disease (OR, 8.74; 95% CI, 3.99-19.13), a history of Cesarean section (OR, 0.20; 95% CI, 0.077-0.53), and presence of PBC in first-degree relatives (OR, 21.1; 95% CI, 6.52-68.0) in the model for medical and familial factors. CONCLUSIONS: These results suggest that poor environmental hygiene in childhood (vault toilets and unpaved roads) and chronic exposure to chemicals (smoking and hair dye use) are likely to be risk factors for the development of PBC in Japan.
BACKGROUND: Primary biliary cholangitis (PBC) is considered to be caused by the interaction between genetic background and environmental triggers. Previous case-control studies have indicated the associations of environmental factors (tobacco smoking, a history of urinary tract infection, and hair dye) use with PBC. Therefore, we conducted a multicenter case-control study to identify the environmental factors associated with the development of PBC in Japan. METHODS: From 21 participating centers in Japan, we prospectively enrolled 548 patients with PBC (male/female = 78/470, median age 66), and 548 age- and sex-matched controls. These participants completed a questionnaire comprising 121 items with respect to demographic, anthropometric, socioeconomic features, lifestyle, medical/familial history, and reproductive history in female individuals. The association was determined using conditional multivariate logistic regression analysis. RESULTS: The identified factors were vault toilet at home in childhood [odds ratio (OR), 1.63; 95% confidence interval (CI), 1.01-2.62], unpaved roads around the house in childhood (OR, 1.43; 95% CI, 1.07-1.92), ever smoking (OR, 1.70; 95% CI, 1.28-2.25), and hair dye use (OR, 1.57; 95% CI, 1.15-2.14) in the model for lifestyle factors, and a history of any type of autoimmune disease (OR, 8.74; 95% CI, 3.99-19.13), a history of Cesarean section (OR, 0.20; 95% CI, 0.077-0.53), and presence of PBC in first-degree relatives (OR, 21.1; 95% CI, 6.52-68.0) in the model for medical and familial factors. CONCLUSIONS: These results suggest that poor environmental hygiene in childhood (vault toilets and unpaved roads) and chronic exposure to chemicals (smoking and hair dye use) are likely to be risk factors for the development of PBC in Japan.
Authors: Roberto Rosa; Laura Cristoferi; Atsushi Tanaka; Pietro Invernizzi Journal: Best Pract Res Clin Gastroenterol Date: 2018-05-16 Impact factor: 3.043
Authors: Xuan Guoyun; Ding Dawei; Liu Ning; Hu Yinan; Yang Fangfang; Tian Siyuan; Sun Hao; Yang Jiaqi; Xu Ang; Guo Guanya; Chen Xi; Shang Yulong; Han Ying Journal: Front Pharmacol Date: 2022-08-30 Impact factor: 5.988