title: Questionnaire based assessment of risk factors for primary biliary cirrhosis.
abstract: BACKGROUND
  Primary biliary cirrhosis is a cholestatic liver disease characterized by immune-mediated destruction of bile ducts. Its pathogenesis is largely unknown, although complex interactions between environment and genetic predisposition are proposed.
  
  
  OBJECTIVE
  Identify disease risk factors using a detailed patient questionnaire and compare study findings to 3 published reports.
  
  
  METHODS
  Questionnaire data were prospectively collected from 522 cases and 616 controls of the Mayo Clinic Primary Biliary Cirrhosis Genetic Epidemiology Registry. Case and control responses were compared using logistic regression, adjusting for recruitment age, sex, and education level.
  
  
  RESULTS
  Cases reported ever regularly smoking cigarettes more frequently than controls (P < 0.001). History of urinary tract infection was similar between groups; however, cases reported multiple urinary tract infections more commonly than controls (P < 0.001). Frequency of other autoimmune disease was higher in cases than controls (P < 0.001). As well, prevalence of primary biliary cirrhosis among first-degree relatives was higher in case families than control families (P < 0.001).
  
  
  CONCLUSIONS
  Our study confirms prior reported risk factors associated with disease risk. Given the potential importance of gene and environment interactions, further examination of environmental risk factors considering genetic background may provide new insight into primary biliary cirrhosis pathogenesis.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Lammert
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Nguyen
authors.forename: Brian D
authors.initials: BD
authors.lastname: Juran
authors.forename: Erik
authors.initials: E
authors.lastname: Schlicht
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Larson
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Atkinson
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Lazaridis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology; D055815:Young Adult