The global, regional, and national burden of inflammatory bowel diseases, 1990-2019: A systematic analysis for the global burden of disease study 2019

Dissecting the rising tide of inflammatory bowel disease among youth in a changing world: insights from GBD 2021

OBJECTIVES

This study investigates the alarming epidemiological trends of inflammatory bowel disease (IBD) among children and young adults, highlighting the associated disease burden on global health.

MATERIALS AND METHODS

Utilizing data from the Global Burden of Disease (GBD) study 2021, we conducted a comprehensive analysis of age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs), and estimated annual percentage changes (EAPC). Future trends were forecasted using the Bayesian age-period-cohort model.

RESULTS

From 1990 to 2021, IBD incidence and DALY rates remained persistently high, with a concerning upward trend noted among children and young adults. While men experienced a decline in DALY rates, women faced increasing burdens. In 2021, high-income regions, particularly North America, reported the highest incidence and DALY rates, contrasting sharply with Central Latin America, which exhibited the lowest ASIR. Southeast Asia presented the most favorable DALY rates. A notable negative correlation was identified between DALY rates and socio-demographic index (SDI) at the national level, with high and high-middle SDI countries continuing to bear a substantial burden, while low and middle SDI nations faced rising challenges.

CONCLUSIONS

The persistent high burden of IBD in children and young adults signifies a critical public health concern. The marked geographical and gender disparities underscore the urgent need for tailored regional and population-based strategies aimed at primary prevention and effective management. This study illuminates the pressing necessity for policy interventions to address the growing epidemic of IBD among vulnerable populations.

Exposure to ambient high temperature and increased risk of hospitalisation for non-infectious bowel diseases during 2000-2019: a case-crossover study in 1816 Brazilian cities

OBJECTIVES

Although human intestine is sensitive to high ambient temperature, the heat-related morbidity burden remains rarely explored. This study quantified the association between high ambient temperature and non-infectious bowel disease (NBD) hospitalisations in Brazil during 2000-2019-a country experiencing substantial threats both from global warming and NBDs.

METHODS

Daily data on weather and NBD hospitalisations were collected from 1816 cities. A time-stratified case-crossover design was used to assess the effect size of ambient temperature during the hot season. Stratified analysis by regions, population subgroups and disease types was performed.

RESULTS

For each 5℃ increase in mean daily temperature, the cumulative OR of NBD hospitalisation over lag 0-3 days was 1.042 (95% CI 1.031 to 1.054) at the national level, reaching the maximum in the northeast and the minimum in the southeast. Assuming a causal relationship, ambient heat exposure explained 12.09% (95% CI 8.69% to 15.09%) of the total hospitalisations. The effect size was the highest in the youth, with no significant gender difference observed. Inflammation-related and function-related NBDs showed significantly higher susceptibility compared with other types of NBDs. The cumulative effect of ambient high temperature attenuated over the 20 years and from early to late hot season, suggesting both long-term and intraseasonal adaptations to heat.

CONCLUSIONS

The spatial, temporal and demographic variations in the strength of association should be considered for the development of health preventive strategies towards extreme ambient heat.

The Time to Inflammatory Bowel Disease Diagnosis for Patients Presenting with Abdominal Symptoms in Primary Care and its Association with Emergency Hospital Admissions and Surgery: A Retrospective Cohort Study

BACKGROUND

Patients with inflammatory bowel disease (IBD) presenting to primary care may experience diagnostic delays. We aimed to evaluate this and assess whether time to diagnosis is associated with clinical outcomes.

METHODS

A retrospective cohort study using English primary care data from January 1, 2010, to December 31, 2019, linked to hospital admission data was undertaken. Patients were followed from the first IBD-related presentation in primary care to IBD diagnosis. Associations of time to diagnosis exceeding a year were assessed using a Robust Poisson regression model. Associations between time to diagnosis and IBD-related emergency hospital admissions and surgery were assessed using Poisson and Cox proportional hazards models, respectively.

RESULTS

Of 28 092 IBD patients, 60% had ulcerative colitis (UC) and 40% had Crohn's disease (CD). The median age was 43 (interquartile range, 30-58) years and 51.9% were female. Median time to diagnosis was 15.6 (interquartile range, 4.3-28.1) months. Factors associated with more than a year to diagnosis included female sex (adjusted risk ratio [aRR], 1.23; 95% CI, 1.21-1.26), older age (aRR, 1.05; 95% CI, 1.01-1.10; comparing >70 years of age with 18-30 years of age), obesity (aRR, 1.03; 95% CI, 1.00-1.06), smoking (aRR, 1.05; 95% CI, 1.02-1.08), CD compared with UC (aRR, 1.13; 95% CI, 1.11-1.16), and a fecal calprotectin over 500 μg/g (aRR, 0.89; 95% CI, 0.82-0.95). The highest quartile of time to diagnosis compared with the lowest was associated with IBD-related emergency admissions (incidence rate ratio, 1.06; 95% CI, 1.01-1.11).

CONCLUSION

Longer times to IBD diagnoses were associated with being female, advanced age, obesity, smoking, and Crohn's disease. More IBD-related emergency admissions were observed in patients with a prolonged time to diagnosis.

Healthy eating patterns associated with reduced risk of inflammatory bowel disease by lowering low-grade inflammation: evidence from a large prospective cohort study

BACKGROUND

Limited epidemiological evidence exists regarding the role of healthy eating patterns in reducing the risk of Crohn's disease (CD) and ulcerative colitis (UC). This study aimed to investigate the association between adherence to four established healthy eating patterns and subsequent CD or UC risk, and further examined whether these associations are linked to anti-inflammatory mechanisms.

METHODS

We conducted a prospective cohort study of 197,391 participants from the UK Biobank who completed at least one dietary questionnaire and were free from inflammatory bowel disease or cancer at baseline. Four dietary patterns were assessed, including Alternate Mediterranean Diet (AMED), Healthy Eating Index 2015 (HEI-2015), Healthful Plant-based Diet Index (HPDI), and EAT-Lancet. Cox proportional models with restricted cubic splines were applied to explore the associations. The potential role of low-grade inflammation in these associations was examined through mediation analysis.

RESULTS

During 2,193,436 person-years follow-up, 260 CD and 601 UC cases were identified. Higher AMED and HEI-2015 scores were associated with a reduced risk of CD but no UC, with no evidence against nonlinearity. These associations remained consistent across multiple sensitive and subgroup analyses. For dietary components, the fruits and monounsaturated fatty acids: saturated fatty acids ratio in AMED, and total fruits, total protein foods and fatty acid in HEI-2015 were linked to a decreased CD risk. Both diets were also associated with lower plasma inflammation biomarkers. Mediation analysis indicated that 7.66% and 13.40% of the reductions in CD risk attributed to AMED and HEI-2015 diets, respectively, were mediated by low-grade inflammation scores.

CONCLUSIONS

Higher adherence to AMED and HEI-2015 might significantly reduce CD risk, partly due to their anti-inflammatory properties.

A novel metric of autoimmune disease burden and its estimated incidence across different stages in life cycle of women

AIM

To produce a unique metric 'autoimmune disease (ADs)' based on various single autoimmune disorder and estimate its case number and age-standardized rate of incidence for each stage in life cycle of women from 1990 to 2019, and to further explore their temporal trends at global, regional, and national levels.

METHODS

A comprehensive classification for life cycle of women was proposed. The estimates and 95 % uncertainty intervals (UIs) for case number and rate of incidence for rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, psoriasis, and type 1 diabetes mellitus in all age groups (< 1, 1-4, 5-9, 10-14, 15-19, 20-24, 25-29, ……,80-84, 85-89, 90-94, 95+) were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. 'ADs' was defined by combining these five disorders. Age standardization by direct method was utilized to estimate the age-standardized rate (ASR) of incidence of 'ADs' for each stage in life cycle of women. Joinpoint regression analysis was adopted to investigate temporal trends of ASR from 1990 to 2019 by calculating annual percentage change (APC) and average APC (AAPC). Associations of incidence in 2019 and change in incidence from 1990 to 2019, with Socio-demographic Index (SDI) were also explored.

RESULTS

In 2019, global ASR of incidence of 'ADs' in childhood, adolescence, adulthood, senility, women of childbearing age, perimenopause, menopause, and sex mature adults at the best reproductive age were 45.46 (95 % CI: 36.40 to 55.09), 59.97(95 % CI:46.62 to 75.30), 104.45 (95 % CI: 84.55 to 127.79), 129.58 (95 % CI: 105.18 to 157.68), 89.51 (95 % CI: 71.94 to 110.35), 130.92 (95 % CI: 106.98 to 158.16), 132.94 (95 % CI: 108.76 to 160.90) and 85.78 (95 % CI: 68.72 to 106.37), respectively. Regionally, although ASR in eight life stages differed from distinct geographical areas, the top three highest ASR all occurred in Western Europe, Australasia, and High-income North America. From 1990 to 2019, global ASR in childhood (AAPC: -0.39, [95 % CI: -0.4 to -0.38], p < 0.001), adolescence (AAPC: -0.4, [95 % CI: -0.41 to -0.4], p < 0.001), adulthood (AAPC: -0.53, [95 % CI: -0.55 to -0.51], p < 0.001), senility (AAPC: -0.4, [95 % CI: -0.41 to -0.38], p < 0.001), women of childbearing age (AAPC: -0.53, [95 % CI: -0.55 to -0.5], p < 0.001), perimenopause (AAPC: -0.56, [95 % CI: -0.59 to -0.52], p < 0.001), menopause (AAPC: -0.56, [95 % CI: -0.59 to -0.53], p < 0.001), and sex mature adults at the best reproductive age (AAPC: -0.5, [95 % CI: -0.51 to -0.49], p < 0.001) all significantly decreased. Nationally, ASR and its temporal trends in eight life stages varied significantly across 204 countries and territories. Additionally, incidence in 2019 and change in incidence from 1990 to 2019 were positively correlated with SDI across nations.

CONCLUSIONS

Significant heterogeneities in incidence of autoimmune diseases across nations, with higher sociodemographic development level presenting higher burden, suggest that flexible health policy and targeted resource allocation tailored to sociodemographic status are crucial for each country.

An epidemiological investigation of the prevalence of digestive diseases in the older prisoner population in Taiwan

OBJECTIVE

The prison population has been increasing globally, and prisoner health is an important issue of global health. However, it has not received sufficient attention, especially in developing countries and regions. Among all the prisoners, the health status of older prisoners requires special attention due to their declining health and energy. This study aims to assess the prevalence of digestive diseases among older prisoners in Taiwan.

METHODS

Data on older prisoners from the National Health Insurance Research Database from January 1 to December 31, 2013, were used in this study. Digestive diseases were assessed in 2,215 older prisoners using the International Classification of Diseases, 9th revision Clinical Modification (ICD-9-CM). We identified the most common digestive diseases and explored any sex-specific differences in their prevalence.

RESULTS

The estimated prevalence of digestive system diseases among the prisoners was 51.56%. Older women prisoners had a higher prevalence (62.68%) compared to men prisoners in general (50.80%). Diseases with a prevalence > 10% include esophageal, gastric, and duodenal diseases; diseases of the oral cavity, salivary glands, and jaws; and other intestinal and peritoneal diseases. Women prisoners showed a significantly higher prevalence of diseases of the oral cavity, salivary glands, jaws, esophagus, stomach, duodenum, non-infectious enteritis, and colitis.

CONCLUSION

Our findings indicate that a considerable number of older prisoners in Taiwan experienced digestive diseases, which may be attributable to general deterioration of physical function and poor resistance. Early detection and treatment are crucial for these conditions, and it is important to maintain human rights and justice in prison systems.

Analysis of global prevalence, DALY and trends of inflammatory bowel disease and their correlations with sociodemographic index: Data from 1990 to 2019

BACKGROUND

Inflammatory bowel disease (IBD) is a kind of chronic inflammatory disorders of the gastrointestinal tract with diverse prevalence rates and patterns globally. Accurate comprehension of the disease's epidemiological characteristics is imperative for disease control and prevention all over the world.

OBJECTIVE

To provide the most updated estimates on the global burden of IBD using the 2019 Global Burden of Disease (GBD) study data, to systematically analyze the IBD epidemiological characteristics at the global, regional, and national levels including the prevalence, incidence, and disability-adjusted life years (DALY) rates, and to analyze the correlations of the socioeconomic development level with IBD epidemiological characteristics.

METHODS

We conducted an overall analysis of the global, regional, and national burden of IBD from 1990 to 2019, data from the 2019 GBD study. The GBD's classification of the world into 21 regions and 204 countries and territories facilitated a thorough examination. Age-standardized estimated annual percentage changes (EAPCs) were computed to assess the temporal trends in IBD age-standardized rates (ASRs), with age standardization employed to mitigate potential confounding effects from age structure. The sociodemographic Index (SDI) was used to correlate the socioeconomic development level with the epidemiological characteristics of IBD.

RESULTS

From 1990 to 2019, the global age-standardized prevalence, incidence, and DALY rates of IBD remained high. There was a slight downward trend in the global age-standardized incidence and DALY rates of IBD and men exhibited higher DALY rates than women. In 2019, high-income North America recorded the highest age-standardized prevalence, incidence, and DALY rates, while Oceania had the lowest age-standardized prevalence and incidence rates. South Asia had the lowest age-standardized DALY rates. The age-standardized mortality and DALY rates decreased as SDI values increased and remained higher than the expected levels over the past three decades. A negative correlation was observed between age-standardized DALY rates and SDI at the national level.

CONCLUSIONS

This analysis of the GBD 2019 database demonstrates that the overall global burden of IBD is still high. Meanwhile, an increasing disease burden is observed in the middle and low SDI locations.

Hospital admissions for pyoderma gangrenosum in Spain (1999-2021): Epidemiological and clinical characteristics, temporal trends, and factors associated with poor prognosis and higher cost

Background and Aims

Pyoderma gangrenosum (PG) is a neutrophilic inflammatory dermatosis that can be idiopathic or associated with other diseases. The aim was to analyze the epidemiological and clinical characteristics, temporal trends, risk factors for poor prognosis, and admission costs associated with PG in Spain.

Methods

We conducted a retrospective study, based on the Hospital Discharge Registry of the Spanish National Health System in Spain from 1999 to 2021.

Results

Of 82,161,670 admissions during the study period, 4901 were for PG (hospitalization rate of 59.7/1,000,000 admissions). PG hospitalizations increased from 28.8/1,00,000 in 1999 to 91.9/1,000,000 in 2021. PG was a primary cause of admission in 60.5% of cases, and 58.4% of patients were women. The main PG-related comorbidities were inflammatory bowel disease (15.7%) and neoplasms (10%). There was a significant increase over the years in admissions for inflammatory bowel disease, monoclonal gammopathy of undetermined significance, and lymphoma, as well as an increase in diseases unrelated to PG, such as hypertension, diabetes, and chronic kidney disease. The hospital mortality rate was 5.6%. Death was associated with PG being a primary diagnosis, older age, leukemia, neoplasms, diabetes, and chronic kidney disease. The cost of treatment increased over the years and was higher in older people.

Conclusion

PG cases in the inpatient setting in Spain over the past 23 years make up a tiny proportion of all hospital admissions, although the rate of hospitalization for PG has increased in the last two decades.

Evaluating Inflammatory Bowel Disease-Related Quality of Life Using an Interpretable Machine Learning Approach: A Multicenter Study in China

Purpose

Impaired quality of life (QOL) is common in patients with inflammatory bowel disease (IBD). A tool to more quickly identify IBD patients at high risk of impaired QOL improves opportunities for earlier intervention and improves long-term prognosis. The purpose of this study was to use a machine learning (ML) approach to develop risk stratification models for evaluating IBD-related QOL impairments.

Patients and Methods

An online questionnaire was used to collect clinical data on 2478 IBD patients from 42 hospitals distributed across 22 provinces in China from September 2021 to May 2022. Eight ML models used to predict the risk of IBD-related QOL impairments were developed and validated. Model performance was evaluated using a set of indexes and the best ML model was explained using a Local Interpretable Model-Agnostic Explanations (LIME) algorithm.

Results

The support vector machine (SVM) classifier algorithm-based model outperformed other ML models with an area under the receiver operating characteristic curve (AUC) and an accuracy of 0.80 and 0.71, respectively. The feature importance calculated by the SVM classifier algorithm revealed that glucocorticoid use, anxiety, abdominal pain, sleep disorders, and more severe disease contributed to a higher risk of impaired QOL, while longer disease course and the use of biological agents and immunosuppressants were associated with a lower risk.

Conclusion

An ML approach for assessing IBD-related QOL impairments is feasible and effective. This mechanism is a promising tool for gastroenterologists to identify IBD patients at high risk of impaired QOL.

Gastrodin Alleviates DSS-Induced Colitis in Mice through Strengthening Intestinal Barrier and Modulating Gut Microbiota

Inflammatory bowel diseases (IBDs) are commonly associated with dysfunctional intestinal barriers and disturbed gut microbiota. Gastrodin, a major bioactive ingredient of Gastrodia elata Blume, has been shown to exhibit anti-oxidation and anti-inflammation properties and could mitigate non-alcoholic fatty liver disease, but its role in modulating IBD remains elusive. The aim of this study was to investigate the impact of gastrodin on DSS-induced colitis in mice and explore its potential mechanisms. Gastrodin supplementation alleviated clinical symptoms such as weight loss, a shortened colon, and a high disease activity index. Meanwhile, gastrodin strengthened the intestinal barrier by increasing the 0expression of tight junction proteins and mucin. Furthermore, Gastrodin significantly reduced pro-inflammatory cytokine secretion in mice by downregulating the NF-κB and MAPK pathways. Gut microbiota analysis showed that gastrodin improved the DSS-disrupted microbiota of mice. These findings demonstrate that gastrodin could attenuate DSS-induced colitis by enhancing the intestinal barrier and modulating the gut microbiota, providing support for the development of a gastrodin-based strategy to prevent or combat IBD.

Parental Inflammatory Bowel Disease with Child Autism: A Comprehensive Review and Meta-Analysis

Inflammatory bowel disease (IBD) has been shown to be connected to a greater possibility of neurologically developed problems, such as autism spectrum disorders (ASDs). However, the proof linking parental IBD with ASD in offspring is inconclusive. Thus, we carried out a meta-analysis and comprehensive review to elucidate such linking. Prior research was identified through reviewing multiple internet-based sources, including Cochrane, Web of Knowledge, Embase, CINAHL, PubMed, and PsycINFO, from 1960 to December 2022. Pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were determined employing random-effects models, in spite of the I2 statistic measurement of heterogeneity. Prediction intervals (PIs) have been presented to allow for more useful inferences and to indicate the range of genuine effects that might be predicted in future scenarios. Six studies (two case-control studies and four cohort studies) involving 3,200,199 participants were incorporated into the meta-analysis. The pooled RRs of ASDs among offspring of IBD parents were 1.15 (95% CI, 0.92 to 1.45, P = 0.226; I2 = 81.4%, P = 0.003; PI, 0.53-2.62), indicating no significant connection between parental IBD and the likelihood of ASDs in children. Type of IBD, and sex both also yielded no statistically significant results according to subgroup analysis. Our meta-analysis does not provide evidence that parental IBD is connected with the elevated likelihood of ASDs in their children. To confirm these results and understand their underlying mechanisms, additional research with larger sample sizes and improved study designs is required.

Identification of therapeutic targets and medicines for comorbid Crohn's disease and rheumatoid arthritis: A comprehensive analysis

Objective

The incidence of Crohn's disease (CD) and rheumatoid arthritis (RA) co-morbidity, as well as the number of individuals affected, is on the rise due to their shared molecular and cellular factors. This study aimed to identify potential therapeutic targets and medicines for comorbid CD and RA.

Methods

We integrated single-cell RNA sequencing, Mendelian randomization, and colocalization analysis results from public databases to analyse immune cell subgroups in CD and RA patients and identify candidate therapeutic targets. We further screened potential medicines for the identified candidate targets using the Comparative Toxicogenomics Database (CTD) and molecular docking and molecular dynamics simulations.

Results

The proportion of CD8 effector memory T cells (Tem) was consistently elevated in the peripheral blood mononuclear cells (PBMCs) of both CD and RA patients. MYBL1 had a causal effect on the onset of both CD (OR = 1.23; 95 % CI, 1.05-1.45; P = 0.046) and RA (OR = 1.45; 95 % CI, 1.14-1.85; P = 0.04). Four potential therapeutic molecules were retrieved from the CTD database, among which tretinoin (docking score: -6.3 kcal/mol) showed the best potential.

Conclusion

Our comprehensive analysis suggests that CD8 Tem cells are a key cell group in comorbid RA and CD and that MYBL1 has a causal effect. Tretinoin was identified as a potential targeted therapeutic drug, which is of great clinical research value.

Compound prebiotics as prophylactic and adjunctive treatments ameliorate DSS-induced colitis through gut microbiota modulation effects

The prophylactic and adjunctive impacts of compound prebiotics (CP), comprising galacto-oligosaccharides, fructo-oligosaccharides, and isomalto-oligosaccharides, on colitis remain unclear. This study aimed to elucidate the effects of CP on dextran sodium sulfate (DSS)-induced colitis via modulation of the gut microbiota. Mice received prophylactic CP (PCP) for three weeks and DSS in the second week. In the third week, therapeutic CP, mesalazine, and a combination of CP and mesalazine (CPM) were administered to mice with DSS-induced colitis. The administration of PCP and CPM was found to ameliorate colitis, as evidenced by increases in body weight and colon length, elevation of the anti-inflammatory cytokine IL-10, and reductions in the disease activity index, histological scores, and levels of pro-inflammatory cytokines in mice with DSS-induced colitis on days 14 or 21. Furthermore, an increase in the relative abundance of probiotics (Ligilactobacillus, Bifidobacterium, and Limosilactobacillus), alpha diversity indices, short-chain fatty acids (SCFA) contents, and microbial network complexity was observed following PCP or CPM treatment. Correlation analysis revealed positive associations between these probiotics and both SCFA and IL-10, and negative associations with pro-inflammatory cytokines. This study highlighted the potential of CP as novel prophylactic and adjunctive treatments for alleviating DSS-induced intestinal inflammation and maintaining gut microbiota homeostasis.

Global, regional, and national burden of inflammatory bowel disease and its associated anemia, 1990 to 2019 and predictions to 2050: An analysis of the global burden of disease study 2019

AIM

Inflammatory bowel disease (IBD) exhibited a global increase in incidence over the past decade. Understanding global burden of IBD can offer valuable insights for shaping future management strategies. We aimed to provide a comprehensive assessment of global burden of IBD from 1990 to 2019 and predictions to 2050.

METHODS

Data on prevalence, incidence, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs) and IBD-attributable impairment factor (anemia) were extracted from the Global Burden of Diseases (GBD) 2019. Subgroup analyses were performed based on gender, geographical regions, and the Socio-Demographic Index (SDI). Joinpoint model, Bayesian age-period-cohort model and decomposition methodology were utilized to evaluate the temporal trends from 1990 to 2019, forecast the disease burden up to 2050 and decompose incidence, prevalence, YLDs and DALYs of IBD by population age structure, population growth and epidemiologic changes.

RESULTS

From 1990 to 2019, number of prevalence, DALYs, YLDs for IBD and number of prevalence for IBD-related-anemia increased significantly. Age-standardized rates of incidence, prevalence, DALYs, and YLDs showed declining trends, with this decline anticipated to continue until 2050 for both genders. The IBD burden remained high in countries with high and high-middle SDI. Besides, countries with low, low-middle, and middle SDI were experiencing an increasing burden. Number and ASR of prevalence and YLDs of IBD related anemia increased with SDI Decomposition analysis indicated that population growth was the primary contributing factor, followed by population aging.

CONCLUSION

Due to population growth and aging, the burden of IBD is projected to continue rising until 2050, which emphasizes the urgency of addressing the evolving public health challenge posed by IBD.

Medical Cannabis Increases Appetite but Not Body Weight in Patients with Inflammatory Bowel Diseases

We aimed to elucidate the effect of Medical Cannabis (MC) on appetite and nutritional status among patients with inflammatory bowel disease (IBD). A case series of patients with IBD were initiating treatment with MC for disease-related symptoms, at the IBD clinic of a tertiary referral medical center. Patients' demographics, anthropometrics, medical history and treatment and MC use were systematically recorded. An appetite and food frequency questionnaire (SNAQ and FFQ) were filled before, and at 3 and 6 months of treatment. Patients with IBD initiating MC were enrolled (n = 149, age 39.0 ± 14.1 years, 42.3% female), and 33.6% (n = 50) were treated for improvement of nutritional status. A modest increase in appetite after 3 months was detected among all patients enrolled (Pv = 0.08), but there were no significant differences in energy or macronutrient intake, and in patients' body mass index (BMI). A significant appetite improvement after 3 months was detected among 34.0% (n = 17) of patients, but this was not associated with increased caloric intake or BMI at 3 or 6 months. Among patients without increased appetite after 3 months of MC therapy, BMI decreased at 6 months (24.1 ± 3.7 vs. 23.4 ± 3.6, Pv = 0.010). MC may be a potential strategy to improve appetite among some patients with IBD, but not caloric intake or BMI.

Epidemiological analysis reveals a surge in inflammatory bowel disease among children and adolescents: A global, regional, and national perspective from 1990 to 2019 - insights from the China study

Background

The burden of inflammatory bowel disease (IBD) among children and adolescents is rising globally, with substantial variation in levels and trends of disease in different countries and regions, while data on the burden and trends were sparse in children and adolescents. We aimed to assess the trends and geographical differences in children and adolescents aged zero to 19 in 204 countries and territories over the past 30 years.

Methods

Data on IBD among children and adolescents was collected from the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. We used the GBD data and methodologies to describe the change in the burden of IBD among children and adolescents involving prevalence, incidence, disability-adjusted life years (DALYs), and mortality.

Results

Globally, the IBD prevalence cases increased between 1990 and 2019. Annual percentage changes (AAPC) = 0.15; 95% confidence interval (CI) = 0.11-0.19, and incidence cases of IBD increased from 20 897.4 (95% CI = 17 008.6-25 520.2 in 1990 to 25 658.6 (95% CI = 21 268.5-31 075.6) in 2019, representing a 22.78% increase, DALYs cases decreased between 1990 and 2019 (AAPC = -3.02; 95% CI = -3.15 to -2.89), and mortality cases of IBD decreased from 2756.5 (95% CI = 1162.6-4484.9) in 1990 to 1208.0 (95% CI = 802.4-1651.4) in 2019, representing a 56.17% decrease. Decomposition analysis showed that IBD prevalence and incidence increased significantly, and a trend exhibited a decrease in underlying age and population-adjusted IBD DALYs and mortality rates. Correlation analysis showed that countries with high health care quality and access (HAQ) had relatively higher IBD age-standardised prevalence rate (ASPR) and age-standardised incidence rate (ASIR), but lower age-standardised DALYs rate (ASDR) and age-standardised mortality rate (ASMR).

Conclusions

Global prevalence and incidence rate of IBD among children and adolescents have been increasing from 1990 to 2019, while the DALYs and mortality have been decreasing. Rising prevalence and rising incidence in areas with historically low rates will have crucial health and economic implications.

Antioxidant Therapy in Inflammatory Bowel Disease: A Systematic Review and a Meta-Analysis of Randomized Clinical Trials

The objective of this study is to assess the effectiveness of treatment for inflammatory bowel diseases in modulating oxidative stress biomarkers and cytokine levels. A systematic review of clinical trials was conducted, searching electronic databases including PubMed, Science Direct, and Scopus. After excluding articles that did not meet the inclusion criteria, 19 studies were included in the systematic review and 8 in the meta-analysis (6 for antioxidant capacity, 6 for superoxide dismutase (SOD), and 5 for lipid peroxidation analyzed through malondialdehyde (MDA) levels). SOD was significantly modulated (RR = 0.3764, 95% CI [0.0262 to 0.7267], p = 0.035) but not antioxidant capacity (RR = 0.3424, 95% CI [0.0334 to 0.7183], p = 0.0742) or MDA (RR = -0.8534, 95% CI [-1.9333 to 0.2265], p = 0.1214). Nonetheless, studies investigating oxidative stress biomarkers and cytokines in the context of alternative therapies for IBD treatment are still scarce. This review highlights the potential of antioxidant supplementation in IBD management and underscores the need for further investigations into its effects on oxidative stress biomarkers and cytokines to improve therapeutic approaches for IBD patients.

Investigating the Crime Scene-Molecular Signatures in Inflammatory Bowel Disease

Inflammatory bowel diseases (IBD) are without cure and troublesome to manage because of the considerable diversity between patients and the lack of reliable biomarkers. Several studies have demonstrated that diet, gut microbiota, genetics and other patient factors are essential for disease occurrence and progression. Understanding the link between these factors is crucial for identifying molecular signatures that identify biomarkers to advance the management of IBD. Recent technological breakthroughs and data integration have fuelled the intensity of this research. This research demonstrates that the effect of diet depends on patient factors and gut microbial activity. It also identifies a range of potential biomarkers for IBD management, including mucosa-derived cytokines, gasdermins and neutrophil extracellular traps, all of which need further evaluation before clinical translation. This review provides an update on cutting-edge research in IBD that aims to improve disease management and patient quality of life.