title: Risk factors in German twins with inflammatory bowel disease: results of a questionnaire-based survey.
abstract: BACKGROUND
  Environmental factors may play an important role in the pathogenesis of IBD. The history of patients of the German IBD twin study was analyzed by questionnaires and interviews.
  
  
  METHODS
  Randomly selected German monozygotic (MZ) and dizygotic (DZ) twins with at least one sibling suffering from IBD (n=512) were characterized in detail including demography, medical history and concomitant medications. Controls comprised of non-twin IBD patients (n=392) and healthy subjects (n=207).
  
  
  RESULTS
  The most significant variables that were associated with Crohn's disease (CD) or ulcerative colitis (UC) included living abroad before time of diagnosis (OR, 4.32; 95% CI, 1.57-13.69), high frequency of antibiotic use (MZ CD OR, 5.03; 95% CI 1.61-17.74, DZ CD OR, 7.66; 95% CI, 3.63-16.82, MZ UC OR, 3.82; 95% CI, 1.45-10.56, DZ UC OR, 3.08; CI, 1.63-5.92), high consumption of processed meat including sausage (MZ CD OR, 7.9; 95% CI, 2.15-38.12, DZ CD OR, 10.75; 95% CI, 4.82-25.55, MZ UC OR, 5.69; 95% CI, 1.89-19.48, DZ UC OR, 18.11; 95% CI, 7.34-50.85), and recall of bacterial gastrointestinal infections (MZ CD OR, 15.9; 95% CI, 4.33-77.14, DZ CD OR, 17.21; 95% CI, 4.47-112.5, MZ UC OR, 5.87; 95% CI, 1.61-28.0, DZ UC OR, 11.34; 95% CI, 4.81-29.67).
  
  
  CONCLUSIONS
  This study reinforced the association of life style events, in particular a specific dietary and infections history, with IBD. Alteration of gut flora or alterations of the mucosal immune system in reactivity to the flora could be an important factor to explain the relationship between life-style and disease.
authors.affiliation: Clinic of General Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstrasse 12, 24105 Kiel, Germany. m.spehlmann@mucosa.de
authors.forename: Martina E
authors.initials: ME
authors.lastname: Spehlmann
authors.forename: Alexander Z
authors.initials: AZ
authors.lastname: Begun
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Saroglou
authors.forename: Frank
authors.initials: F
authors.lastname: Hinrichs
authors.forename: Ute
authors.initials: U
authors.lastname: Tiemann
authors.forename: Andreas
authors.initials: A
authors.lastname: Raedler
authors.forename: Stefan
authors.initials: S
authors.lastname: Schreiber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003093:Colitis, Ulcerative / Q000209:etiology*; D003141:Communicable Diseases / Q000150:complications; D015897:Comorbidity; D003424:Crohn Disease / Q000209:etiology*; D004032:Diet; D004200:Diseases in Twins / Q000209:etiology*; D005260:Female; D005858:Germany; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014429:Twins, Dizygotic; D014430:Twins, Monozygotic; D055815:Young Adult