P688 Crohn's disease patients with a concordant family history are diagnosed earlier and are at increased risk for complicated disease
Notice bibliographique
Résumé
Background: Family history is the strongest risk factor for developing Crohn's disease (CD) or ulcerative colitis (UC). However, whether familial Inflammatory Bowel Disease (IBD) differs from sporadic IBD in its natural history has not been well defined. We investigated whether the proximity of relationship with the affected relative and concordance for type of IBD modifies the effect of family history on the phenotype and severity of IBD. Methods: This study included patients with a confirmed diagnosis of IBD enrolled in a prospective patient registry at a tertiary referral hospital from January 2005 to August 2016. Family history of CD or UC was assessed by a questionnaire ascertaining presence of disease in a 1st degree (parent, child, sibling), 2nd degree (grandparent, uncle, aunt), or a distant relative (familial IBD). IBD occurring in the absence of such a history was termed sporadic IBD. Our primary outcomes were disease phenotype according to the Montreal classification and severity measured by need for immunomodulator, biologic, or surgical therapy. Adjusted regression models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: Our study included 2,136 patients with IBD (1,197 CD, 939 UC) with a mean age of 41 years; just over half were women (52%). Just under one-third (32%) of cases were familial IBD (17% 1st degree relative, 21% 2nd degree relative) while the remainder were sporadic IBD. Familial IBD was diagnosed at an earlier age than sporadic IBD, both in CD (26 vs. 28 years, p=0.0006) and UC (29 vs. 32 years, p=0.01). This effect was more striking in those where the family history was concordant for type of IBD (p=0.0005) than when it was discordant (p=0.06). Among CD patients, a positive family history for CD was associated with an increased risk for complicated disease (B2/B3 phenotype or perianal involvement) in the presence of an affected family member (OR 1.48, 95% CI 1.07–2.03). However, this effect was significant only if the affected member was a 1st degree relative (OR 1.82, 95% CI 1.19– 2.78) (Table 1). Figure 1 Among 1st degree relatives, the association with complicated CD was more striking in the presence of CD in a sibling (p=0.008). A family history was not associated with need for immunosuppressive therapy or surgery in either CD or UC. Conclusions: A family history of CD in 1st degree relatives was associated with complicated CD. Family history discordant for type of IBD or in more distant relatives did not influence disease phenotype or natural history in the affected patient.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».