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. 2025 Sep 26;25:666. doi: 10.1186/s12876-025-04230-1

Table 7.

Association between water hardness and the risk of CD by genetic susceptibility

Low genetic risk High genetic risk
P for interaction HR (95% CI) P HR (95% CI) P
Water hardness (USGS, mg/l) 0–60 ref ref ref
60–120 0.250 0.87 (0.65–1.16) 0.342 0.92 (0.75–1.14) 0.211
120–180 0.124 0.35 (0.17–0.70) 0.003 0.66 (0.45–0.97) 0.035
> 180 0.794 0.74 (0.57–0.95) 0.019 0.89 (0.75–1.07) 0.457
P for trend 0.008 0.162
Water hardness (WHO, mg/l) < 200 ref ref ref
≥ 200 0.427 0.83 (0.66–1.05) 0.127 0.94 (0.80–1.10) 0.446
CaCO3 concentration (per SD) 0.348 0.88 (0.79–0.99) 0.032 0.95 (0.88–1.02) 0.171
Ca concentration (per SD) 0.272 0.90 (0.80–1.01) 0.085 0.97 (0.90–1.05) 0.462
Mg concentration (per SD) 0.655 0.02 (0.81–1.05) 0.226 0.95 (0.88–1.04) 0.285

Abbreviations: USGS United States Geological Survey, WHO World Health Organization, HR hazards ratio, P p-values

Adjusted for age, sex, CCI scores, BMI, IPAQ physical activity, alcohol consumption, smoking status, ethnicity, TDI, diet quality scores, the first five principal components of ancestry genetics

Bold font for USGS and WHO water hardness groups indicates p < 0.025, while bold font for other variables indicates p < 0.05