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E-pub ahead of print

Risk factors for developing Inflammatory Bowel Disease Within and Across Families with Family History of IBD

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INTRODUCTION: A family history of IBD is the strongest risk factor for disease. However, some first-degree relatives (FDRs) will develop disease, while others will not.

METHODS: Using the nationwide Danish National Patient Register, we examined risk factors in families with ≥2 affected FDRs. First, we compared exposures between siblings with and without IBD within the same family (within family analysis). Second, we compared exposures between individuals with and without IBD across all families (across family analysis). Exposures included sex, birth order, mode of delivery, antibiotics, personal and family history of immune-mediated diseases, gastrointestinal infections, and surgical history preceding diagnosis. Uni- and multivariable conditional logistic regression analyses were conducted.

RESULTS: In the "within family analysis", 1669 families were included (1,732 cases, 2,447 controls). Female sex (adjusted odds ratio (aOR): 1.40, 95% CI 1.23, 1.59), history of ankylosing spondylitis (aOR: 2.88, 95% CI 1.05, 7.91) and exposure to antibiotics (aOR: 1.28, 95% CI 1.02, 1.61), increased the risk for IBD. In the "across family analysis", 1,254 cases and 37,584 controls were included, confirming association with prior ankylosing spondylitis (aOR: 3.92, 95% CI 1.38, 11.12), and exposure to antibiotics (aOR: 1.29, 95% CI 1.04, 1.60). Having ≥2 relatives (aOR: 6.26, 95% CI 1.34, 29.29) or a sibling with IBD (aOR: 1.36, 95% CI 1.18, 1.57), increased the risk of IBD. Appendectomy reduced the risk of UC (aOR: 0.32, 95% CI 0.14, 0.72).

CONCLUSION: In families with IBD, we identified risk factors for the unaffected FDR to develop disease. These findings provide an opportunity for counselling IBD relatives.

TidsskriftJournal of Crohn's & colitis
StatusE-pub ahead of print - 9 aug. 2022

Bibliografisk note

© The Author(s) 2022. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email:

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