| خلاصه مقاله | Background: Bechet’s disease (BD) is a chronic inflammatory multisystem disease
characterised by recurrent oral and genital aphthous ulcers, uveitis and skin
lesions. Smoking play an important role in the development of inflammatory
diseases.1
Objectives: BD is an inflammatory disease and smoking may have a role in its
triggering. Although few studies reported association between smoking and clinical
manifestations of BD, to the best of our knowledge, there is no research on the
risk of developing BD in smokers.2–4 This case-control study was conducted to
investigate the association between smoking and the risk of BD.
Methods: We included 192 patients with BD and 822 healthy siblings of patient
with BD and 373 age and sex matched healthy unrelated persons as control
groups (table 1). Written informed consent was obtained from all the participants.
Demographic data and smoking history of patients and their siblings were
obtained by direct and in some cases by telephone interview with the participants.
Demographic data and smoking history of healthy controls were obtained by direct
interview. Current and former smokers were classified together as ever smokers
for the purposes of this analysis. We carried out multivariate analyses with a logistic
regression model with BD as the main outcome variable and smoking history
as the main predictor variable. Models were adjusted for age, gender, marital status,
educational status and pack-years.
Results: The patients with BD were more often ever smokers than healthy siblings
of patients and healthy unrelated controls (table 1). However, pack-years of
smoking in control groups were significantly more than the BD group. By multivariate
logistic regression and after adjustment for age, sex, marital status and educational
status (model 1), ever smoking was significantly associated with an
increased risk of BD compared with never smoking. In comparison with healthy
siblings and healthy unrelated persons who never smoked, the relative risk (RR)
of developing BD was 1.43 and 1.51, respectively. After including pack year in
multivariate analysis (model 2), the RR of developing BD in ever smokers
increased to 2.23 and 2.01, respectively.No significant differences were observed in the clinical manifestations of BD
patients in ever smokers and never smokers. However, disease activity, at disease
presentation and last visit in ever smokers was significantly more than never
smokers.
Conclusions: Our data suggest that smoking is a significant risk factor for BD
and genetic factors may play an important role in the developing of BD in smokers.
We also show a particularly strong relationship between smoking with BD activity
and response to treatment. |