Risk of Prevalent Asthma among Children Affected by Inflammatory Bowel Disease: A Population-Based Birth Cohort Study.

Claudio Barbiellini Amidei,Loris Zanier,Fabiana Zingone,Cristina Canova

doi:10.3390/ijerph17124255

Claudio Barbiellini Amidei, Loris Zanier + Show 2 more

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https://doi.org/10.3390/ijerph17124255

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Abstract

Literature on the risk of asthma among children with inflammatory bowel disease (IBD) is limited and has reported discording results. To the best of our knowledge, no previous study has evaluated the association between asthma and childhood onset IBD, focusing on pediatric IBD with onset between 10 and 17 years, early-onset IBD (EO-IBD) between 0 and 9 years, and very early-onset IBD (VEO-IBD) between 0 and 5 years, all conditions characterized by different clinical progressions. A nested matched case-control design on a longitudinal cohort of 213,515 newborns was adopted. Conditional binomial regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) of asthma among children with IBD compared with controls. We found 162 children with IBD and 1620 controls. Overall, childhood onset IBD was associated with increased risks of being affected by asthma (OR: 1.49 95% CI 1.05–2.12), although a significant risk was only present among males (OR: 1.60 95% CI 1.02–2.51). Children with Crohn’s disease and ulcerative colitis had similarly increased risks, although they failed to attain statistical significance. Risks of asthma based on age at IBD onset were inversely related to age, with the lowest non-significant risks for pediatric IBD and EO-IBD, while children affected by VEO-IBD had the highest risk of asthma (OR: 2.75 95% CI 1.26–6.02). Our study suggests the presence of a higher prevalence of asthma among both male children with IBD and children with VEO-IBD. It could be advisable to pay greater attention to possible respiratory symptoms among these categories at higher risk.

Highlights

Inflammatory bowel disease (IBD) and asthma are two relevant and very impactful immune-mediated diseases that share common genetic and environmental risk factors [1].IBD consists of a group of relapsing conditions that includes Crohn’s disease and ulcerative colitis, characterized by chronic inflammation of the gastrointestinal tract, a progressive course, and potential development of complications including extra-intestinal manifestations
Childhood onset IBD was associated with increased risks of being affected by asthma (OR: 1.49 95% confidence intervals (CI) 1.05–2.12), a significant risk was only present among males (OR: 1.60 95% CI 1.02–2.51)
Our study suggests the presence of a higher prevalence of asthma among both male children with IBD and children with very early-onset IBD (VEO-IBD)

Summary

Introduction

IBD consists of a group of relapsing conditions that includes Crohn’s disease and ulcerative colitis, characterized by chronic inflammation of the gastrointestinal tract, a progressive course, and potential development of complications including extra-intestinal manifestations. IBD can occur at any age, with the highest incidence between 15 and 29 years [2,3]. 18 years) is increasing especially in Western countries, with a stable incidence before 6 years of age, but an increasing trend between 6 and 16 years [4,5]. Gender-based differences seem to vary according to the type of IBD, as recently shown by a pooled analysis on the prevalence of IBD in Western countries, according to which more male children are affected by Crohn’s disease among patients aged 0 to. Public Health 2020, 17, 4255; doi:10.3390/ijerph17124255 www.mdpi.com/journal/ijerph

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