title: Familial pulmonary fibrosis is the strongest risk factor for idiopathic pulmonary fibrosis.
abstract: Idiopathic pulmonary fibrosis (IPF) is a lethal lung disorder of unknown etiology. The disease is likely the result of complex interactions between genetic and environmental factors. Evidence suggests that certain environmental factors, such as cigarette smoking and metal dust exposures, or comorbidities like gastroesophageal reflux, and type 2 diabetes mellitus (DM2) may increase risk to develop IPF. Substantial uncertainty remains, however, regarding these and other putative risk factors for IPF. In this study we performed a case-control analysis including 100 patients with IPF and 263 controls matched for age sex and place of residence. We used a structured questionnaire to identify potential risk factors for IPF, including environmental and occupational exposures as well as the relevance of family history of pulmonary fibrosis. The multivariate analysis revealed that family history of pulmonary fibrosis [OR = 6.1, CI95% 2.3-15.9; p < 0.0001] was strongly associated with increased risk of IPF. Actually, 20% of the cases reported a parent or sibling with pulmonary fibrosis. Gastroesophageal reflux [OR = 2.9, CI: 1.3-6.6; p = 0.007], former cigarette smoking [OR = 2.5, CI: 1.4-4.6, p = 0.003], and past or current occupational exposure to dusts, smokes, gases or chemicals [OR = 2.8, CI: 1.5-5.5; p = 0.002] were also associated with the disease. Despite being a significant risk factor on univariate analysis DM2 was not significant in multivariate analysis. These findings indicate that family history of pulmonary fibrosis is a strong risk factor for IPF. Also, we confirmed that occupational exposures, gastroesophageal reflux and former smoking increase the risk for this disease.
authors.affiliation: Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Tlalpan 4502, 14080 México DF, Mexico.
authors.forename: Cecilia
authors.initials: C
authors.lastname: García-Sancho
authors.forename: Ivette
authors.initials: I
authors.lastname: Buendía-Roldán
authors.forename: Ma Rosario
authors.initials: MR
authors.lastname: Fernández-Plata
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Rogelio
authors.initials: R
authors.lastname: Pérez-Padilla
authors.forename: Mario H
authors.initials: MH
authors.lastname: Vargas
authors.forename: James E
authors.initials: JE
authors.lastname: Loyd
authors.forename: Moisés
authors.initials: M
authors.lastname: Selman
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D004391:Dust; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000453:epidemiology; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008670:Metals / Q000009:adverse effects*; D015999:Multivariate Analysis; D016273:Occupational Exposure / Q000009:adverse effects*; D011658:Pulmonary Fibrosis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D004391:Dust; D008670:Metals