Familial incidence linked to risk for IBD in first-degree relatives
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Individuals who have a sibling with inflammatory bowel disease had a fourfold-increased risk for IBD compared with the general population, according to research published in Alimentary Pharmacology & Therapeutics.
“A family history of IBD is a proxy for an individual’s genetic and, in part, environmental risk of developing the disease and has long been recognized as the strongest risk factor for IBD. ... From an etiological point of view, studies of familial aggregation of IBD may shed light on the impact of genetic and environmental risk factors,” Jonas F. Halfvarson, MD, PhD, of the department of gastroenterology at Orebro University in Sweden, and colleagues wrote. “This motivates studies that provide precise estimates of the future risk of IBD in first-degree relatives of newly diagnosed IBD patients.”
In a nationwide, case-control study, Halfvarson and colleagues used Swedish national registers to identify 50,667 patients diagnosed with IBD between 2003 and 2017 who had at least one first-degree relative with IBD and compared them with 506,720 controls from the general population, matching for age, sex, birth year and county of residence. Studied outcomes included calculated odds for patients with IBD to have a relative with IBD and incidence of future IBD among relatives.
Compared with controls, patients with IBD were more likely to have a first-degree relative with IBD, regardless of disease type, including a mother (3% vs. 0.9%; OR = 3.5; 95% CI, 3.3-3.7), father (2.9% vs. 0.8%; OR = 3.5; 95% CI, 3.3-3.7), full sibling (5.3% vs. 1.5%; OR = 3.6; 95% CI, 3.4-3.8) or child (2.4% vs. 0.9%; OR = 2.6; 95% CI, 2.4-2.8) with IBD. Pediatric-onset Crohn’s disease (OR = 10.6; 95% CI, 8.2-13.5) and ulcerative colitis (OR = 8.4; 95% CI, 6.4-10.9) carried the highest odds. The association strength increased with the number of affected first-degree relatives.
In addition, researchers noted the 10-year cumulative incidence of IBD was 1.7% among full siblings of patients with IBD vs. 0.4% among full siblings of control patients.
“This large nationwide, population-based study provides novel information on several aspects of familial IBD, is of importance for both researchers and clinicians and can help tailor future screening interventions,” Halfvarson and colleagues concluded. “Both age at IBD diagnosis of the index patient and age of the healthy first-degree relative should be taken into account when planning future screening programs and preventive interventions in IBD.”
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