ABSTRACT
Aim: This study aimed to examine the environmental factors associated in Iranian patients with inflammatory bowel disease (IBD). Background: The role of environmental factors in the development of IBD remains uncertain. Methods: In this case-control study, the patients with IBD referred to the Taleghani Hospital, Tehran, Iran, were recruited from 2017 to 2019. Controls were matched by sex. Data were collected using the designed questionnaire and also valid questionnaire such Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) for sleep quality and anxiety/depression, respectively. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs). Results: The study population included 200 individuals: 100 (50%) IBD patients and 100 (50%) controls. Age under 50, marital status, sleep difficulties, vitamin D insufficiency, anxiety/depression, dietary fiber deficit, post-menopausal hormone treatment, oral contraceptives, and antibiotics were all prognostic factors for IBD on the univariate analysis (P< 0.005). In multivariate analysis, the risk of IBD was significantly increased with 50 years (OR: 6.699, 95%CI: 3.271-8.662, P=0.017), abnormal sleep status (OR: 6.383, 95%CI: 3.389-7.19, P=0.001), and using oral contraceptive (OR: 7.426, 95%CI: 5.327-9.865, P=0.001). However, the risk of IBD was significantly decreased with older age (OR: 0.795, 95%CI: 0.697-0.907, P=0.001) and married status (OR: 0.008, 95%CI: 0.001-0.438, P=0.018). Conclusion: Data suggest that the environmental factors play a significant role in the etiology of IBD and probably on the disease course. While the evidence for some factors is strong, many factors require further supportive data.
ABSTRACT
BACKGROUND: The progression rate of liver fibrosis is variable among patients with hepatitis C virus (HCV) infection. It is affected by environmental and genetic factors. We determined the association between ABO blood groups and the severity of liver fibrosis in HCV patients. MATERIALS AND METHODS: This cross-sectional study was conducted on adult patients with chronic HCV infection who referred to university clinics in Isfahan, Iran in 2009-10. Patients with positive hepatitis B surface antigen (HBS Ag), human immunodeficiency virus antibody (HIV Ab), or other liver disorders, as well as those who had received anti-HCV treatments were not included. Blood type was determined and liver biopsy was obtained from all patients. The severity of hepatic fibrosis was graded from F0 to F4 based on METAVIR system. RESULTS: Non-O blood groups were present in 53.8%, 72.3%, 75%, 87.5%, and 90.4% of the patients with F0-F4 grades of liver fibrosis, respectively (p = 0.019). There was no relationship between the severity of hepatic fibrosis and age or gender. In ordinal regression analysis, only the viral load (p = 0.028) and non-O blood group (p = 0.001) were associated with the severity of hepatic fibrosis. CONCLUSION: Non-O blood group is a genetic risk factor for progression of liver fibrosis in patients with HCV infection. It can play an important role in determining the prognosis and appropriate treatment among these patients. The association between blood group and liver fibrosis is probably due to the increased risk of venous thrombosis. Such relation can be the goal of preventive/treatment strategies.
