Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study

Eur J Gastroenterol Hepatol. 2017 May;29(5):587-594. doi: 10.1097/MEG.0000000000000832.

Abstract

Objectives: Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited.

Aim: The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in microscopic colitis.

Methods: A postal questionnaire was sent in 2008-2009 to microscopic colitis patients resident in Sweden and three population-based controls per patient, matched for age, sex and municipality.

Results: Some 212 patients and 627 controls participated in the study. There was an association with a family history of microscopic colitis in both CC [odds ratio (OR): 10.3; 95% confidence interval (CI): 2.1-50.4, P=0.004] and LC (OR not estimated, P=0.008). Current smoking was associated with CC [OR: 4.7; 95% CI: 2.4-9.2, P<0.001) and LC (OR: 3.2; 95% CI: 1.6-6.7, P=0.002). The median age at diagnosis was around 10 years earlier in ever-smokers compared with never-smokers.CC was associated with a history of ulcerative colitis (UC) (OR: 8.7, 95% CI: 2.2-33.7, P=0.002), thyroid disease (OR: 2.3; 95% CI: 1.1-4.5, P=0.02), coeliac disease (OR: 13.1; 95% CI: 2.7-62.7, P=0.001), rheumatic disease (OR 1.9; 95% CI: 1.0-3.5, P=0.042) and previous appendicectomy (OR: 2.2; 95% CI: 1.3-3.8, P=0.003), and LC with UC (OR: 6.8; 95% CI: 1.7-28.0, P=0.008), thyroid disease (OR: 2.4; 95% CI: 1.1-5.4, P=0.037) and coeliac disease (OR: 8.7; 95% CI: 2.8-26.7, P<0.001).

Conclusion: Association with a family history of microscopic colitis indicates that familial factors may be important. The association with a history of UC should be studied further as it may present new insights into the pathogenesis of microscopic colitis and UC.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Autoimmune Diseases / epidemiology
  • Case-Control Studies
  • Colitis, Collagenous / diagnosis
  • Colitis, Collagenous / epidemiology
  • Colitis, Collagenous / etiology
  • Colitis, Collagenous / genetics
  • Colitis, Lymphocytic / diagnosis
  • Colitis, Lymphocytic / epidemiology
  • Colitis, Lymphocytic / etiology
  • Colitis, Lymphocytic / genetics
  • Colitis, Microscopic / diagnosis
  • Colitis, Microscopic / epidemiology
  • Colitis, Microscopic / etiology*
  • Colitis, Microscopic / genetics
  • Colitis, Ulcerative / epidemiology
  • Comorbidity
  • Educational Status
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Male
  • Marital Status
  • Middle Aged
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Sweden / epidemiology