Abstract
BackgroundEnvironmental factors during childhood are thought to play a role in the aetiology of Crohn’s Disease (CD). In South Africa, recently published work based on an investigation of 14 childhood environmental exposures during 3 age intervals (0–5, 6–10 and 11–18 years) has provided insight into the role of timing of exposure in the future development of CD. The ‘overlapping’ contribution of the investigated variables however, remains unclear. The aim of this study was to perform a post hoc analysis using this data and investigate the extent to which each variable contributes to the subsequent development of CD relative to each aforementioned age interval, based on a score analysis approach.MethodsThree methods were used for the score analysis. Two methods employed the subgrouping of one or more (similar) variables (methods A and B), with each subgroup assigned a score value weighting equal to one. For comparison, the third approach (method 0) involved no grouping of the 14 variables. Thus, each variable held a score value of one.ResultsResults of the score analysis (Method 0) for the environmental exposures during 3 age intervals (0–5, 6–10 and 11–18 years) revealed no significant difference between the case and control groups. By contrast, results from Method A and Method B revealed a significant difference during all 3 age intervals between the case and control groups, with cases having significantly lower exposure scores (approximately 30% and 40% lower, respectively).ConclusionResults from the score analysis provide insight into the ‘compound’ effects from multiple environmental exposures in the aetiology of CD.
Highlights
Results from Method A and Method B revealed a significant difference during all 3 age intervals between the case and control groups, with cases having significantly lower exposure scores
Environmental risk factors in childhood are believed to play a role in the subsequent development of the inflammatory bowel disease (IBD) subtype, Crohn’s disease (CD) [1,2,3,4]
All exposures were equal to the value of one, the total possible score was 14 (Table 1)
Summary
Environmental risk factors in childhood are believed to play a role in the subsequent development of the inflammatory bowel disease (IBD) subtype, Crohn’s disease (CD) [1,2,3,4]. Numerous studies have evaluated the different environmental exposures during childhood, albeit findings for many have been inconsistent [4,5,6,7,8,9,10,11,12,13,14] These inconsistencies may be attributed to differences in both the timing and the extent of the various environmental exposures during childhood, as well as the heterogeneity in CD susceptibility mutations both between and within individual population groups [15, 16]. These findings may be a result of methodological issues such as study sample size, participant characteristics (i.e. demographics, socioeconomic factors), identification of inappropriate control subjects, or the failure to account for potential confounding environmental variables. The aim of this study was to perform a post hoc analysis using this data and investigate the extent to which each variable contributes to the subsequent development of CD relative to each aforementioned age interval, based on a score analysis approach
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