An envirogenomic signature is associated with risk of IBD-related surgery in a population-based Crohn’s Disease cohort
Nasir, Bushra F., Griffiths, Lyn R., Nasir, Aslam, Roberts, Rebecca, Barclay, Murray, Gearry, Richard B., & Lea, Rod A. (2013) An envirogenomic signature is associated with risk of IBD-related surgery in a population-based Crohn’s Disease cohort. Journal of Gastrointestinal Surgery, 17(9), pp. 1643-1650.
BACKGROUND AND AIMS:
Crohn's disease (CD) is an inflammatory bowel disease (IBD) caused by a combination of genetic, clinical, and environmental factors. Identification of CD patients at high risk of requiring surgery may assist clinicians to decide on a top-down or step-up treatment approach.
We conducted a retrospective case-control analysis of a population-based cohort of 503 CD patients. A regression-based data reduction approach was used to systematically analyse 63 genomic, clinical and environmental factors for association with IBD-related surgery as the primary outcome variable.
A multi-factor model was identified that yielded the highest predictive accuracy for need for surgery. The factors included in the model were the NOD2 genotype (OR = 1.607, P = 2.3 × 10(-5)), having ever had perianal disease (OR = 2.847, P = 4 × 10(-6)), being post-diagnosis smokers (OR = 6.312, P = 7.4 × 10(-3)), being an ex-smoker at diagnosis (OR = 2.405, P = 1.1 × 10(-3)) and age (OR = 1.012, P = 4.4 × 10(-3)). Diagnostic testing for this multi-factor model produced an area under the curve of 0.681 (P = 1 × 10(-4)) and an odds ratio of 3.169, (95 % CI P = 1 × 10(-4)) which was higher than any factor considered independently.
The results of this study require validation in other populations but represent a step forward in the development of more accurate prognostic tests for clinicians to prescribe the most optimal treatment approach for complicated CD patients.
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|Item Type:||Journal Article|
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
|Copyright Owner:||Copyright 2013 Springer|
|Deposited On:||12 Sep 2013 01:31|
|Last Modified:||02 Jul 2014 22:18|
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