ISG Winter Meeting 2015
Young Investigator Award 2015
Mr Ivan Yu
Mr Ivan Yu is a medical student of University College Dublin (UCD) currently completing his final year. He entered the UCD medical programme in 2011 having received the UCD Entrance Scholar Award. While attending medical school, Mr. Yu found a passion for medicine and paediatrics in particular which led to electives in Cardiology and Paediatric Gastroenterology. These learning opportunities afforded Mr. Yu a chance to experience research, which led to the "Aetiological risk factors for developing paediatric inflammatory bowel disease in a prospective cohort" project. At UCD, Mr . Yu has participated in many clubs and societies including Badminton, Hockey and the UCD Orchestra. He continues to play Badminton at club level.
Aetiological risk factors for developing paediatric inflammatory bowel disease in a prospective cohort
Ivan Yu1, Eleanor O’Neill1, Rebecca Stanley1, Aoife Carey2,3, Siobhain Kiernan3, Mary Hamzawi3, Karen O’Driscoll3, Shoana Quinn3, Annemarie Broderick1,3, Billy Bourke1-3, Tara Rafferty2,3, Séamus Hussey
1. Academic Centre for Paediatric Research, School of Medicine and Medical Science, University College Dublin. National Children’s Research Centre, Crumlin, Dublin 12 3. Our Lady’s Children Hospital, Crumlin, Dublin.
The incidence of paediatric inflammatory bowel disease (PIBD) has increased 3-fold in the past 15 years. Aetiological factors underlying this are not well known.
To assess potential familial, demographic and environmental risk factors for developing PIBD in a prospective national cohort of patients.
Parents of participants in the DOCHAS study (Determinants and Outcomes in Children and Adolescents with IBD Study) were asked to complete a standardised questionnaire at diagnosis. Patients diagnosed between January 1st 2012 and June 30th 2015 were included. Information including prediagnosis home environment, location, household density, smoking exposure, medication exposure as well as extended family histories was recorded prospectively. Patients were classified according to the Paris Classification of PIBD. Data was exported from the study database to exel format for data analysis, using descriptive statistics where applicable.
A total of 356 subjects were recruited, including 64 controls, 145 with Crohn disease (CD) and 123 with ulcerative colitis (UC). More males than females were diagnosed with CD (3:1), whereas in UC the M:F ratio was (1:1.1). The mean age of those with UC was 13.1 yr, and CD was 12.7 yr. Rural dwelling was observed in 37% with CD and 40% with UC. Twenty six percent had a positive family history of IBD, with 5% having a maternal family history in particular. Compared with controls, PIBD was associated with maternal smoking during pregnancy (11.48% vs 24.7%, p=0.02). A family history of autoimmune disease had a more likely diagnosis of CD than that of UC (46% vs 28%, p=0.001); this was mirrored in patients with autoimmune disease (54% vs 18%, p<0.001). Patient and paternal atopic diseases were more associated with CD than UC (40% vs 19%, p<0.001 and 12% vs 5%, p=0.049 respectively), and conditions such as maternal type 1 diabetes, patient and paternal autoimmune thyroid disease and patient celiac disease were also significantly associated with PIBD. There were no significant differences between patients with CD and UC in relation to prior antibiotic use, NSAID exposure, previous infective enteritis or appendicectomy.
This is the first prospective study of potential risk factors for developing PIBD. Gender, maternal smoking exposure, maternal family history of IBD and a family history of autoimmune disease were associated significantly with certain IBD phenotypes. Ongoing prospective research is required to further elucidate these associations.