Hamed Khalili|Leslie M. Higuchi|Ashwin N. Ananthakrishnan|JoAnn E. Manson|Diane Feskanich|James M. Richter|Charles S. Fuchs|Andrew T. Chan
Hormone Therapy Increases Risk of Ulcerative Colitis but not Crohn's Disease
Massachusetts General Hospital|Harvard University|Boston Children's Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Brigham and Women's Hospital|Harvard University|Brigham and Women's Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Dana-Farber Cancer Institute|Brigham and Women's Hospital|Harvard University|Massachusetts General Hospital|Harvard University|Brigham and Women's Hospital
background aimsestrogen proposed modulate gut inflammation effect estrogen receptors found gastrointestinal epithelial immune cells role postmenopausal hormone therapy risk crohns disease cd ulcerative colitis uc unclearmethodswe conducted prospective cohort study 108844 postmenopausal us women median age 54 years enrolled 1976 nurses health study without prior history cd uc every 2 years updated information menopause status postmenopausal hormone use risk factors selfreported diagnoses cd uc confirmed medical record review 2 gastroenterologists blinded exposure information used cox proportional hazards models calculate adjusted hazard ratios hrs 95 confidence intervals cisresultsthrough 2008 18 million personyears followup documented 138 incident cases cd 138 cases uc compared women never used hormones multivariateadjusted hr uc 171 95 ci 107274 among women currently used hormones 165 95 ci 103266 among past users risk uc appeared increase longer duration hormone use ptrend 04 decreased time since discontinuation difference risk according type hormone therapy used estrogen vs estrogen plus progestin contrast observe association current use hormones risk cd multivariateadjusted hr 119 95 ci 078182 effect hormones risk uc cd modified age body mass index smokingconclusionsin large prospective cohort women postmenopausal hormone therapy associated increased risk uc cd findings indicate pathways related estrogens might mediate pathogenesis uc estrogen proposed modulate gut inflammation effect estrogen receptors found gastrointestinal epithelial immune cells role postmenopausal hormone therapy risk crohns disease cd ulcerative colitis uc unclear conducted prospective cohort study 108844 postmenopausal us women median age 54 years enrolled 1976 nurses health study without prior history cd uc every 2 years updated information menopause status postmenopausal hormone use risk factors selfreported diagnoses cd uc confirmed medical record review 2 gastroenterologists blinded exposure information used cox proportional hazards models calculate adjusted hazard ratios hrs 95 confidence intervals cis 2008 18 million personyears followup documented 138 incident cases cd 138 cases uc compared women never used hormones multivariateadjusted hr uc 171 95 ci 107274 among women currently used hormones 165 95 ci 103266 among past users risk uc appeared increase longer duration hormone use ptrend 04 decreased time since discontinuation difference risk according type hormone therapy used estrogen vs estrogen plus progestin contrast observe association current use hormones risk cd multivariateadjusted hr 119 95 ci 078182 effect hormones risk uc cd modified age body mass index smoking large prospective cohort women postmenopausal hormone therapy associated increased risk uc cd findings indicate pathways related estrogens might mediate pathogenesis uc