Family history of IBD linked to younger diagnosis, complications
CHICAGO — Researchers associated close-relative family history of Crohn’s disease with earlier diagnosis of Crohn’s disease in patients and increased risk of related complications while, overall, family history of inflammatory bowel disease predicted a younger age of diagnosis, according to data presented at Digestive Disease Week.
“As we know IBD, which combines Crohn’s disease and ulcerative colitis, is a chronic, progressive disease and the incidence of IBD is still growing worldwide,” Nynke Z. Borren, MD, from the Massachusetts General Hospital, said in a presentation. “Genetic factors play an important role in the pathogenesis of UC and CD, with over 200 distinct risk polymorphisms identified. Previous studies have shown that family history is one of the strongest risk factors for developing Crohn’s disease or UC.”
The researchers analyzed the family history of Crohn’s disease and ulcerative colitis in patients with irritable bowel disease, divided by “first degree” relation (parent, child, sibling), “second degree” relation (grandparent, uncle, aunt) or distant relative. The study comprised 2,136 patients with IBD, either Crohn’s disease (n = 1,197) or ulcerative colitis (n = 939). Mean patient age was 41 years and 52% were women.
Among the 32% of patients who had family history of IBD, 11% were first degree relations, 15% were second degree relations and 6% were in both categories. The remainder of patients had no family history of IBD and their diagnosis was considered sporadic.
Among patients with family history of IBD, patients were more likely to be male (P = .006), have a higher level of education (P = .015) and had a longer mean duration of IBD (P < .001). Patients with family history of IBD were diagnosed at an earlier age compared with sporadic patients for both Crohn’s disease (26 vs. 28 years; P = .0006) and UC (29 vs. 31 years; P = .01). This outcome was more prevalent in cases of concordant diagnosis of IBD (P = .005) than discordant cases.
In cases of patients with Crohn’s disease who had a family history of Crohn’s disease, there was a significant association for complicated disease related to the B2/B3 phenotype or perianal involvement (OR 1.82; 95% CI 1.07-2.03), which was significant in first degree relations (OR 1.82; 95% CI, 1.19-2.78). Additionally, in cases of first degree relations, the association with complicated Crohn’s disease was more prevalent in relations with siblings (P = .008) than with parent or child.
“Positive family history is associated with a younger age of diagnosis,” Borren concluded. “Family history discordant for type of IBD or in distant relatives did not influence disease phenotype [nor did it] have an effect on disease severity independent of effect on phenotype.” – by Talitha Bennett
Borren NZ, et al. Abstract 21. Presented at: Digestive Disease Week; May 6-9, 2017; Chicago.
Disclosure : Borren reports no relevant financial disclosures.