title: Multicenter case-control study of the risk factors for ulcerative colitis in China.
abstract: OBJECTIVE
  To evaluate potential risk factors in the development of ulcerative colitis (UC) in China.
  
  
  METHODS
  A total of 1308 patients with UC and 1308 age-matched and sex-matched controls were prospectively studied in China. The UC cases were collected from 17 hospitals in China from April 2007 to April 2010. Uniform questionnaires were designed to investigate risk factors including smoking, appendectomy, stress, socio-economic conditions, nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, diet, breastfeeding, infections and family sanitary conditions. Group comparisons by each factor were done using simple logistic regression analysis. Conditional logistic regression was used for multivariate analysis.
  
  
  RESULTS
  By univariate analysis, the variables predictive of UC included feeling stress, light and heavy alcoholic drinking, spicy food, sugar consumption and infectious diarrhea, while heavy tea intake and tap water consumption were protective against UC. On multivariate analysis, the protective factor for UC was tap water consumption [odds ratios (OR) = 0.424, 95%CI: 0.302-0.594, P < 0.001]; while the potential risk factors for UC were heavy sugar consumption (OR = 1.632, 95%CI: 1.156-2.305, P < 0.001), spicy food (light intake: OR = 3.329, 95%CI: 2.282-4.857, P < 0.001; heavy intake: OR = 3.979, 95%CI: 2.700-5.863, P < 0.001), and often feeling stress (OR = 1.981, 95%CI: 1.447-2.711, P < 0.001). Other factors, such as smoking habit, appendectomy, breastfeeding, a history of measles, rural or urban residence, education, oral contraceptives, and NSAID use have not been found to have a significant association with the development of UC in the present study.
  
  
  CONCLUSIONS
  Our study showed tap water consumption was a protective factor for UC, while spicy food, heavy sugar consumption and often feeling stress were risk factors for UC in this Chinese population.
authors.affiliation: Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Yu-Fang
authors.initials: YF
authors.lastname: Wang
authors.forename: Qin
authors.initials: Q
authors.lastname: Ou-Yang
authors.forename: Bing
authors.initials: B
authors.lastname: Xia
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Liu
authors.forename: Fang
authors.initials: F
authors.lastname: Gu
authors.forename: Kai-Fang
authors.initials: KF
authors.lastname: Zhou
authors.forename: Qiao
authors.initials: Q
authors.lastname: Mei
authors.forename: Rui-Hua
authors.initials: RH
authors.lastname: Shi
authors.forename: Zhi-Hua
authors.initials: ZH
authors.lastname: Ran
authors.forename: Xiao-Di
authors.initials: XD
authors.lastname: Wang
authors.forename: Pin-Jin
authors.initials: PJ
authors.lastname: Hu
authors.forename: Kai-Chun
authors.initials: KC
authors.lastname: Wu
authors.forename: Xin-Guang
authors.initials: XG
authors.lastname: Liu
authors.forename: Ying-Lei
authors.initials: YL
authors.lastname: Miao
authors.forename: Ying
authors.initials: Y
authors.lastname: Han
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Wu
authors.forename: Guo-Bing
authors.initials: GB
authors.lastname: He
authors.forename: Jie
authors.initials: J
authors.lastname: Zhong
authors.forename: Guan-Jian
authors.initials: GJ
authors.lastname: Liu
mesh_terms: D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000517:prevention & control; D004032:Diet / Q000009:adverse effects; D004040:Dietary Carbohydrates / Q000009:adverse effects; D005247:Feeding Behavior; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012499:Sanitation; D017365:Spices / Q000009:adverse effects; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014881:Water Supply
chemical_list: D004040:Dietary Carbohydrates
keywords: Case-control study; Risk factors; Ulcerative colitis
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