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Ratajczak AE, Szymczak-Tomczak A, Rychter AM, Zawada A, Dobrowolska A, Krela-Kaźmierczak I. Impact of Cigarette Smoking on the Risk of Osteoporosis in Inflammatory Bowel Diseases. J Clin Med 2021; 10:1515. [PMID: 33916465 PMCID: PMC8038608 DOI: 10.3390/jcm10071515] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 12/14/2022] Open
Abstract
Cigarette smoking constitutes one of the most important modifiable factors of osteoporosis, as well as contributes to an early death, tumors, and numerous chronic diseases. The group with an increased risk of a lower bone mineral density are patients suffering from inflammatory bowel diseases. In fact, tobacco smoke, which contains more than 7000 chemical compounds, affects bone mineral density (BMD) both directly and indirectly, as it has an impact on the RANK-RANKL-OPG pathway, intestinal microbiota composition, and calcium-phosphate balance. Constant cigarette use interferes with the production of protective mucus and inhibits the repair processes in the intestinal mucus. Nicotine as well as the other compounds of the cigarette smoke are important risk factors of the inflammatory bowel disease and osteoporosis. Additionally, cigarette smoking may decrease BMD in the IBD patients. Interestingly, it affects patients with Crohn's disease and ulcerative colitis in different ways-on the one hand it protects against ulcerative colitis, whereas on the other it increases the risk of Crohn's disease development. Nevertheless, all patients should be encouraged to cease smoking in order to decrease the risk of developing other disorders.
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Affiliation(s)
- Alicja Ewa Ratajczak
- Correspondence: (A.E.R.); (I.K.-K.); Tel.: +48-667-385-996 (A.E.R.); +48-8691-343 (I.K.-K.); Fax: +48-8691-686 (A.E.R.)
| | | | | | | | | | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznań University of Medical Sciences, 61-701 Poznań, Poland; (A.S.-T.); (A.M.R.); (A.Z.); (A.D.)
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Thomas T, Chandan JS, Li VSW, Lai CY, Tang W, Bhala N, Kaplan GG, Ng SC, Ghosh S. Global smoking trends in inflammatory bowel disease: A systematic review of inception cohorts. PLoS One 2019; 14:e0221961. [PMID: 31545811 PMCID: PMC6756556 DOI: 10.1371/journal.pone.0221961] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 08/18/2019] [Indexed: 12/18/2022] Open
Abstract
Background and aims The effect of smoking on the risk of developing inflammatory bowel diseases (IBD) may be heterogeneous across ethnicity and geography. Although trends in smoking for the general population are well described, it is unknown whether these can be extrapolated to the IBD cohort. Smoking prevalence trends specific to the global IBD cohort over time have not been previously reported. This is a systematic review of smoking prevalence specific to the IBD cohort across geography. Methods A systematic literature search was conducted on Medline and Embase from January 1st 1946 to April 5th 2018 to identify population-based studies assessing the prevalence of smoking at diagnosis in inception cohorts of Crohn’s disease(CD) or ulcerative colitis(UC). Studies that did not report smoking data from time of diagnosis or the year of IBD diagnosis were excluded. Prevalence of smoking in IBD was stratified by geography and across time. Results We identified 56 studies that were eligible for inclusion. Smoking prevalence data at diagnosis of CD and UC was collected from twenty and twenty-five countries respectively. Never-smokers in the newly diagnosed CD population in the West has increased over the last two decades, especially in the United Kingdom and Sweden; +26.6% and +11.2% respectively. Never-smokers at CD diagnosis in newly industrialised nations have decreased over the 1990s and 2000s; China (-19.36%). Never-smokers at UC diagnosis also decreased in China; -15.4%. The former-smoker population at UC diagnosis in China is expanding; 11%(1990–2006) to 34%(2011–2013). Conclusion There has been a reduction in the prevalence of smoking in the IBD cohort in the West. This is not consistent globally. Although, smoking prevalence has decreased in the general population of newly industrialised nations, this remains an important risk factor with longer term outcomes awaiting translation in both UC and CD.
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Affiliation(s)
- Tom Thomas
- Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- * E-mail:
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Venice Sze Wai Li
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong, China
| | - Cheuk Yin Lai
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong, China
| | - Whitney Tang
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong, China
| | - Neeraj Bhala
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Gilaad G. Kaplan
- Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Siew C. Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong, China
| | - Subrata Ghosh
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- NIHR Biomedical Research Centre Birmingham, Institute of Translational Medicine, University of Birmingham, Birmingham, United Kingdom
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Chaparro M, Barreiro-de Acosta M, Benítez JM, Cabriada JL, Casanova MJ, Ceballos D, Esteve M, Fernández H, Ginard D, Gomollón F, Lorente R, Nos P, Riestra S, Rivero M, Robledo P, Rodríguez C, Sicilia B, Torrella E, Garre A, García-Esquinas E, Rodríguez-Artalejo F, Gisbert JP. EpidemIBD: rationale and design of a large-scale epidemiological study of inflammatory bowel disease in Spain. Therap Adv Gastroenterol 2019; 12:1756284819847034. [PMID: 31205485 PMCID: PMC6535735 DOI: 10.1177/1756284819847034] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/25/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is associated with a considerable burden to the patient and society. However, current data on IBD incidence and burden are limited because of the paucity of nationwide epidemiological studies, heterogeneous designs, and a low number of participating centers and sample size. The EpidemIBD study is a large-scale investigation to provide an accurate assessment of the incidence of IBD in Spain, as well as treatment patterns and outcomes. METHODS This multicenter, population-based incidence cohort study included patients aged >18 years with IBD (Crohn's disease, ulcerative colitis, or unclassified IBD) diagnosed during 2017 in 108 hospitals in Spain, covering 50% of the Spanish population. Each participating patient will attend 10 clinic visits during 5 years of follow up. Demographic data, IBD characteristics and family history, complications, treatments, surgeries, and hospital admissions will be recorded. RESULTS The EpidemIBD study is the first large-scale nationwide study to investigate the incidence of IBD in Spain. Enrollment is now completed and 3627 patients are currently being followed up. CONCLUSIONS The study has been designed to overcome many of the limitations of previous European studies into IBD incidence by prospectively recruiting a large number of patients from all regions of Spain. In addition to epidemiological information about the burden of IBD, the 5-year follow-up period will also provide information on treatment patterns, and the natural history and financial burden of IBD.
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Affiliation(s)
| | - Manuel Barreiro-de Acosta
- Gastrointestinal Units of Complexo Hospitalario
Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - José Manuel Benítez
- Gastrointestinal Units of Hospital Universitario
Reina Sofía and IMIBIC, Córdoba, Spain
| | - José Luis Cabriada
- Gastrointestinal Units of Hospital de
Galdakao-Usansolo, Galdakao, Vizcaya, Spain
| | - María José Casanova
- Gastrointestinal Units of Hospital Universitario
de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP),
Universidad Autónoma de Madrid, and Centro de Investigación Biomédica en Red
de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Daniel Ceballos
- Gastrointestinal Units of Hospital Universitario
de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - María Esteve
- Gastrointestinal Units of Hospital Universitari
Mutua Terrassa and CIBERehd, Terrassa, Barcelona, Spain
| | | | - Daniel Ginard
- Gastrointestinal Units of Hospital Universitari
Son Espases, Palma de Mallorca, Spain
| | - Fernando Gomollón
- Gastrointestinal Units of Hospital Clínico
Universitario “Lozano Blesa”, IIS Aragón and CIBERehd, Zaragoza, Spain
| | - Rufo Lorente
- Gastrointestinal Units of Hospital General
Universitario de Ciudad Real, Ciudad Real, Spain
| | - Pilar Nos
- Gastrointestinal Units of Hospital Universitari
i Politecnic La Fe and CIBERehd, Valencia, Spain
| | - Sabino Riestra
- Gastrointestinal Units of Hospital
Universitario Central de Asturias and Instituto de Investigación Sanitaria
del Principado de Asturias (ISPA), Oviedo, Spain
| | - Montserrat Rivero
- Gastrointestinal Units of Hospital
Universitario Marqués de Valdecilla and IDIVAL, Santander, Spain
| | - Pilar Robledo
- Gastrointestinal Units of Hospital
Universitario San Pedro de Alcántara, Cáceres, Spain
| | - Cristina Rodríguez
- Gastrointestinal Units of Complejo Hospitalario
de Navarra, Pamplona, Spain
| | - Beatriz Sicilia
- Gastrointestinal Units of Hospital
Universitario de Burgos, Burgos, Spain
| | - Emilio Torrella
- Gastrointestinal Units of Hospital General
Universitario J.M. Morales Meseguer, Murcia, Spain
| | - Ana Garre
- Gastrointestinal Units of Hospital
Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa
(IIS-IP), Universidad Autónoma de Madrid, and Centro de Investigación
Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid,
Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public
Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and
CIBERESP, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public
Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and
CIBERESP, Madrid, Spain
| | - Javier P. Gisbert
- Gastrointestinal Units of Hospital
Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa
(IIS-IP), Universidad Autónoma de Madrid, and Centro de Investigación
Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid,
Spain
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Brunet E, Roig-Ramos C, Vela E, Clèries M, Melcarne L, Villòria A, Pontes C, Calvet X. Prevalence, incidence and mortality of inflammatory bowel disease in Catalonia. A population-based analysis. Ann Med 2018; 50:613-619. [PMID: 30247071 DOI: 10.1080/07853890.2018.1523550] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Few recent data on the epidemiology of inflammatory bowel disease (IBD) are available, especially in Southern Europe. AIM To evaluate the prevalence, incidence and mortality of IBD in Catalonia during the period 2011-2016. MATERIAL AND METHODS Data on the prevalence, incidence and mortality of IBD were obtained from the Catalan Health Surveillance System (CHSS). Crude incidence and prevalence rates were calculated for all the Catalan population. Trends in age-sex-adjusted rates were also estimated, and logistic regression was used to calculate the adjusted mortality odds ratio (OR). Data for Crohn's disease (CD) and ulcerative colitis (UC) were analyzed separately. RESULTS The prevalence per 100,000 inhabitants in 2016 was 353.9 for UC and 191.4 for CD. The total number of IBD patients rose from 29543 in 2011 to 40614 in 2016. IBD was associated with significantly elevated adjusted mortality ratios: 1.28 (95% CI: 1.6-1.4) for UC and 1.85 (95% CI: 1.62-2.12) for CD. CONCLUSIONS IBD prevalence is very high and is increasing rapidly in Catalonia. Both CD and UC are associated with significantly higher mortality rates. Key message Crohn disease and ulcerative colitis present a small but significant increase in mortality compared to non-inflammatory bowel disease. The prevalence of inflammatory bowel disease is increasing rapidly in Catalonia. Data on prevalence and incidence suggest that the number of patients may double in approximately 10 years.
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Affiliation(s)
- Eduard Brunet
- a Servei Aparell Digestiu, Hospital Universitari Parc Taulí , Sabadell , Spain
| | - Cristina Roig-Ramos
- a Servei Aparell Digestiu, Hospital Universitari Parc Taulí , Sabadell , Spain
| | - Emili Vela
- b Unitat d'Informació i Coneixement. Servei Català de la Salut, Generalitat de Catalunya , Barcelona, Spain
| | - Montserrat Clèries
- b Unitat d'Informació i Coneixement. Servei Català de la Salut, Generalitat de Catalunya , Barcelona, Spain
| | - Luigi Melcarne
- a Servei Aparell Digestiu, Hospital Universitari Parc Taulí , Sabadell , Spain
| | - Albert Villòria
- a Servei Aparell Digestiu, Hospital Universitari Parc Taulí , Sabadell , Spain.,c Departament de Medicina , Universitat Autònoma de Barcelona , Bellaterra , Spain.,d CIBERehd, Instituto de Salud Carlos III , Madrid , Spain
| | - Caridad Pontes
- e Àrea del Medicament. Servei Català de la Salut , Barcelona , Spain.,f Departament de Farmacologia , de terapéutica i de Toxicologia. Universitat Autònoma de Barcelona , Bellaterra , Spain
| | - Xavier Calvet
- a Servei Aparell Digestiu, Hospital Universitari Parc Taulí , Sabadell , Spain.,c Departament de Medicina , Universitat Autònoma de Barcelona , Bellaterra , Spain.,d CIBERehd, Instituto de Salud Carlos III , Madrid , Spain
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Shah SC, Khalili H, Gower-Rousseau C, Olen O, Benchimol EI, Lynge E, Nielsen KR, Brassard P, Vutcovici M, Bitton A, Bernstein CN, Leddin D, Tamim H, Stefansson T, Loftus EV, Moum B, Tang W, Ng SC, Gearry R, Sincic B, Bell S, Sands BE, Lakatos PL, Végh Z, Ott C, Kaplan GG, Burisch J, Colombel JF. Sex-Based Differences in Incidence of Inflammatory Bowel Diseases-Pooled Analysis of Population-Based Studies From Western Countries. Gastroenterology 2018; 155:1079-1089.e3. [PMID: 29958857 DOI: 10.1053/j.gastro.2018.06.043] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/12/2018] [Accepted: 06/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Although the incidence of inflammatory bowel diseases (IBDs) varies with age, few studies have examined variations between the sexes. We therefore used population data from established cohorts to analyze sex differences in IBD incidence according to age at diagnosis. METHODS We identified population-based cohorts of patients with IBD for which incidence and age data were available (17 distinct cohorts from 16 regions of Europe, North America, Australia, and New Zealand). We collected data through December 2016 on 95,605 incident cases of Crohn's disease (CD) (42,831 male and 52,774 female) and 112,004 incident cases of ulcerative colitis (UC) (61,672 male and 50,332 female). We pooled incidence rate ratios of CD and UC for the combined cohort and compared differences according to sex using random effects meta-analysis. RESULTS Female patients had a lower risk of CD during childhood, until the age range of 10-14 years (incidence rate ratio, 0.70; 95% CI, 0.53-0.93), but they had a higher risk of CD thereafter, which was statistically significant for the age groups of 25-29 years and older than 35 years. The incidence of UC did not differ significantly for female vs male patients (except for the age group of 5-9 years) until age 45 years; thereafter, men had a significantly higher incidence of ulcerative colitis than women. CONCLUSIONS In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.
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Affiliation(s)
- Shailja C Shah
- Division of Gastroenterology, Mount Sinai Hospital, New York, New York; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Hamed Khalili
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Corinne Gower-Rousseau
- Public Health Unit, Epimad Registre, Lille University Hospital, France; INSERM LIRIC, UMR 995, Lille University, France
| | - Ola Olen
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eric I Benchimol
- CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Department of Pediatrics and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Elsebeth Lynge
- Division of Gastroenterology, University of Copenhagen, Copenhagen, Denmark
| | - Kári R Nielsen
- Division of Gastroenterology, National Hospital, Tórshavn, Faroe Islands
| | - Paul Brassard
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Maria Vutcovici
- Department of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada
| | - Alain Bitton
- Department of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada
| | - Charles N Bernstein
- Division of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Desmond Leddin
- Division of Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hala Tamim
- Division of Gastroenterology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tryggvi Stefansson
- Division of Gastroenterology, National University Hospital of Iceland, Reykjavík, Iceland
| | - Edward V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, New York
| | - Bjørn Moum
- Department of Gastroenterology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Whitney Tang
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Richard Gearry
- Division of Gastroenterology, University of Otago, Christchurch, New Zealand
| | - Brankica Sincic
- Division of Gastroenterology, University of Rijeka, Rijeka, Croatia
| | - Sally Bell
- Division of Gastroenterology, St. Vincent's Hospital, Melbourne, Australia
| | - Bruce E Sands
- Division of Gastroenterology, Mount Sinai Hospital, New York, New York
| | - Peter L Lakatos
- Division of Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Zsuzsanna Végh
- Division of Gastroenterology, Semmelweis University, Budapest, Hungary
| | - Claudia Ott
- Division of Gastroenterology, University of Regensburg, Regensburg, Germany
| | - Gilaad G Kaplan
- Department of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Johan Burisch
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
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Cueto Torreblanca I, Camargo Camero R, Andrade Bellido R, Romero Pérez E, Alcaín Martínez G. Epidemiology of inflammatory bowel disease in Málaga: incidence rate and follow-up of a cohort diagnosed between 2007-2008. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2018; 109:572-577. [PMID: 28689424 DOI: 10.17235/reed.2017.4708/2016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
BACKGROUND AND OBJECTIVES The incidence of inflammatory bowel disease (IBD) in Spain has been traditionally lower than in Northern European countries. Recent epidemiological studies have found that these differences are diminishing. This study estimates the incidence of IBD in Málaga (Spain), a city in Southern Spain and relates its results to those found in our neighboring countries. MATERIAL AND METHODS This was a prospective study designed to collect new cases diagnosed during the period from 2007-2008 and follow up these patients. Incidence is expressed as number of patients per 100,000 population per year. The population distribution found in the European Collaborative Study was used to standardize incidence rates. RESULTS The gross incidence rate of IBD in Málaga is 9/105, the standardized incidence rate is 12.3/105 (9.7-15.6). CONCLUSIONS These data are similar to those found in our surroundings, although a higher incidence rate for Crohn's disease (CD) as compared to ulcerative colitis (UC) was found. The clinical characteristics and outcomes of our patients do not differ significantly from those described for other populations.
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Marín-Jiménez I, Saro C, Díaz V, Acosta MBD, Gómez-García M, Casbas AG. Epidemiology and hospital resources use in the treatment of ulcerative colitis at gastroenterology units in Spain (EPICURE study). Drugs Context 2018. [PMID: 29535792 PMCID: PMC5842877 DOI: 10.7573/dic.212505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background and aim Nationwide epidemiological data on ulcerative colitis (UC) in Spain are lacking. The primary objective was to assess the epidemiology of UC at hospital gastroenterology units and the use of hospital resources (characteristics and facilities) for the management of UC in Spain. Methods A retrospective, multicenter, epidemiological, cross-sectional study (EPICURE study) analyzed data from hospital registries and records from UC patients admitted and treated in 2011 at a representative selection of Spanish sites. The prevalence of UC in gastroenterology units was calculated as the total UC patients divided by the total inhabitants covered by those sites. Incidence was defined as the number of new UC cases during 2011 divided by the total inhabitants covered by those sites. Results In 2011, a total of 42,000 patients were attended for UC in gastroenterology units in Spain with a prevalence rate of 88.7 UC cases (95% CI: 69.6-106.0) per 100,000 inhabitants. The incidence rate was of 5.7 cases (95% CI: 1.2-10.8)/100,000 inhabitants. Six percent of patients being attended for UC were hospitalized in the 58 units analyzed in 2011. There were 1075 hospitalizations related to UC in total (approximately 14 per gastroenterology unit; median hospital stay length: 8 days). Six out of 1000 UC patients underwent colectomy in 2011. Near one third (32.7%) were emergency colectomies. Most hospitals had specific IBD units (87.9%) and colorectal surgeons (93.1%). Conclusions Our study provides the first national data on the prevalence and incidence of UC in gastroenterology units in Spain. Hospitalization and surgical burden associated with UC was low.
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Affiliation(s)
- Ignacio Marín-Jiménez
- Unidad de Gastroenterología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Cristina Saro
- Unidad de Gastroenterología, Hospital de Cabueñes, Gijón, Spain
| | | | - Manuel Barreiro-de Acosta
- Unidad de Enfermedad Inflamatoria Intestinal, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - María Gómez-García
- Unidad de Gastroenterología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Ana Gutiérrez Casbas
- Unidad de Gastroenterología, Hospital General Universitario, Alicante, Spain.,Ciberehd Instituto de Salud Carlos III, Madrid, Spain
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Shah A, Talley NJ, Walker M, Koloski N, Morrison M, Burger D, Andrews JM, McGuckin M, Jones M, Holtmann G. Is There a Link Between H. Pylori and the Epidemiology of Crohn's Disease? Dig Dis Sci 2017; 62:2472-2480. [PMID: 28281167 DOI: 10.1007/s10620-017-4496-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 02/08/2017] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Case control studies suggest an inverse association between Helicobacter pylori (H. pylori) and Crohn's disease (CD). It is possible this could be accounted for by confounders such as antibiotic therapy. Analyzing the geographic distribution of H. pylori and the links with the incidence and prevalence of CD would be an alternative approach to circumvent these confounders. METHODS The literature was searched for studies published between 1990 and 2016 that reported incidence or prevalence data for CD in random population samples in developed countries (GDP per capita >20,000 USD/year). Corresponding prevalence studies for H. pylori in these same regions were then sought matched to the same time period (±6 years). The association between the incidence and prevalence of CD and H. pylori prevalence rates were assessed before and after adjusting for GDP and life expectancy. RESULTS A total of 19 CD prevalence and 22 CD incidence studies from 10 European countries, Japan, USA, and Australia with date-matched H. pylori prevalence data were identified. The mean H. pylori prevalence rate was 43.4% (range 15.5-85%), and the mean rates for incidence and prevalence for CD were 6.9 and 91.0/100,000 respectively. The incidence (r = -0.469, p < 0.03) and prevalence (r = -0.527, p = 0.02) of CD was inversely and significantly associated with prevalence of H. pylori infection. CONCLUSIONS Our data demonstrate a significant inverse association between geographic distribution of H. pylori and CD. Thus, it is highly unlikely that the findings of previous case control studies were simply due to confounding factors such as concomitant antibiotic use in CD patients.
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Affiliation(s)
- Ayesha Shah
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Faculty of Medicine and Faculty of Health and Behavioural Sciences, Translational Research Institute, University of Queensland, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia
| | - Nicholas J Talley
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Marjorie Walker
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Natasha Koloski
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Faculty of Medicine and Faculty of Health and Behavioural Sciences, Translational Research Institute, University of Queensland, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia.,Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Mark Morrison
- Microbial Biology and Metagenomics, Diamantina Institute, University of Queensland, Brisbane, QLD, Australia
| | - Daniel Burger
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Faculty of Medicine and Faculty of Health and Behavioural Sciences, Translational Research Institute, University of Queensland, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia
| | - Jane M Andrews
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia
| | - Michael McGuckin
- Mater Medical Research Institute, Translational Research Institute, University of Queensland, Woolloongabba, QLD, Australia
| | - Mike Jones
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Gerald Holtmann
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Faculty of Medicine and Faculty of Health and Behavioural Sciences, Translational Research Institute, University of Queensland, Ipswich Road, Woolloongabba, Brisbane, QLD, Australia.
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Ramos A, Calvet X, Sicilia B, Vergara M, Figuerola A, Motos J, Sastre A, Villoria A, Gomollón F. IBD-related work disability in the community: Prevalence, severity and predictive factors. A cross-sectional study. United European Gastroenterol J 2015; 3:335-42. [PMID: 26279841 DOI: 10.1177/2050640615577532] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 02/21/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND AIMS Data on the prevalence of work disability in patients with inflammatory bowel disease (IBD) are heterogeneous. As most studies have been performed in selected, often severe, IBD patients, the true prevalence of disability in the community remains controversial. The aim of this cross-sectional study was to evaluate the prevalence and severity of disability and its predictive factors in a community-based IBD population. PATIENTS AND METHODS Patients recorded in the community-based IBD register at the Hospital Universitario de Burgos were contacted. After informed consent they completed a set of questionnaires including demographic, clinical, disability and quality of life data. The statistical study was performed using SPSS 21. RESULTS A total of 293 patients were included - 151 Crohn's disease (CD), 142 ulcerative colitis (UC), 137 female, mean age: 45 ± 11 years, mean time since diagnosis: 10.6 ± 11 years. Twelve patients (4.1%) had a work-disability pension. In addition, 93 (32%) of all patients had an officially recognized disability degree, which was generally moderate (n = 73, 25%) or severe (N = 16, 5%). Age, time since IBD diagnosis, CD, perianal disease, incontinence, active disease, the need for anti-TNF or psychological treatment, previous surgeries and the number of diagnostic tests and medical visits in the previous year were predictors of disability. Major predictors of qualifying for a disability pension were age, IBD activity, incontinence, need for biological drugs and ostomy. CONCLUSION Mild to moderate work disability is frequent in IBD. However, only a minority of patients develop severe disability qualifying them for a pension.
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Affiliation(s)
- Alexis Ramos
- Servicio de Aparato Digestivo, Complejo Asistencial de Burgos, Spain
| | - Xavier Calvet
- Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain ; Departament de Medicina, Universitat Autònoma de Barcelona, Spain ; CIBERehd, Instituto de Salud Carlos III, Spain
| | - Beatriz Sicilia
- Servicio de Aparato Digestivo, Complejo Asistencial de Burgos, Spain
| | - Mercedes Vergara
- Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain ; Departament de Medicina, Universitat Autònoma de Barcelona, Spain ; CIBERehd, Instituto de Salud Carlos III, Spain
| | - Ariadna Figuerola
- Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain ; Departament de Medicina, Universitat Autònoma de Barcelona, Spain ; CIBERehd, Instituto de Salud Carlos III, Spain
| | - Jaume Motos
- Fundació Universitària del Bages, Universitat Autònoma de Barcelona, Spain
| | - Adoración Sastre
- Servicio de Aparato Digestivo, Complejo Asistencial de Burgos, Spain
| | - Albert Villoria
- Servei Aparell Digestiu, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain ; Departament de Medicina, Universitat Autònoma de Barcelona, Spain ; CIBERehd, Instituto de Salud Carlos III, Spain
| | - Fernando Gomollón
- CIBERehd, Instituto de Salud Carlos III, Spain ; Servicio de Aparato Digestivo, Hospital Clínico Universitario de Zaragoza, Spain
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Incidence and phenotype at diagnosis of inflammatory bowel disease. Results in Spain of the EpiCom study. GASTROENTEROLOGIA Y HEPATOLOGIA 2015; 38:534-40. [PMID: 25890448 DOI: 10.1016/j.gastrohep.2015.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 02/24/2015] [Accepted: 03/01/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Incidence of inflammatory bowel disease (IBD) is increasing progressively. Few recent epidemiological prospective studies are available in Spain. The Epicom study, a population-based inception cohort of unselected IBD patients developed within the European Crohn's and Colitis Organization, was started in 2010. Vigo is the only Spanish area participating. OBJECTIVE To describe the incidence of IBD in the Vigo area and the phenotypical characteristics at diagnosis and to compare them with previous data available in Spain. MATERIAL AND METHODS Epidemiological, descriptive, prospective, and population-based study. All incident cases of IBD during 2010 and living in the Vigo area at diagnosis were included. The Copenhagen Diagnostic criteria were used to define cases. Background population at the start of the study was 579,632 inhabitants. Data were prospectively entered in the EpiCom database. RESULTS A total of 106 patients were included (57.5% men, median age 39.5 years). Of them 53 were diagnosed of as Crohn's disease (CD), 47 ulcerative colitis (UC) and six IBD unclassified (IBDU). The incidence rate per 100,000 per year for patients aged 15 years or older was 21.4 (10.8 for CD, 9.4 for UC, 1.2 IBDU). Including pediatric population incidence rates were 18.3 (10.3 CD, 8.7 UC, 1.2 IBDU). Median time since onset of symptoms until diagnosis was 2 months. CONCLUSIONS The incidence rate of IBD in Vigo is the highest compared to former Spanish cohorts, especially in CD patients. Median time since onset of symptoms until diagnosis is relatively short.
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11
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FARRUKH A, MAYBERRY JF. INFLAMMATORY BOWEL DISEASE IN HISPANIC COMMUNITIES: a concerted South American approach could identify the aetiology of Crohn’s disease and ulcerative colitis. ARQUIVOS DE GASTROENTEROLOGIA 2014; 51:271-5. [DOI: 10.1590/s0004-28032014000400002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 06/20/2014] [Indexed: 12/24/2022]
Abstract
Despite intensive research we remain ignorant of the cause of both Crohn’s disease and ulcerative colitis. The dramatic rise in incidence, particularly of Crohn’s disease, points towards environmental factors as playing a significant role. A major purpose of this review is to stimulate a co-ordinated international effort to establish an on-going data base in Central and South America in which new cases are registered and through which investigations into aetiology can be conducted. In both Brazil and Mexico there is evidence that the incidence of ulcerative colitis is increasing, as also is the case for Crohn’s disease in Brazil. The pattern of disease is, therefore, directly comparable to that reported from Europe and the USA during the 1970s and 1980s, but much lower than contemporary data from Spain. Although the incidence is similar to that reported from Portugal, the studies from Almada and Braga were conducted a decade before that from Sao Paulo. The situation in Brazil compares dramatically with Uruguay and Argentina where the reported incidence of inflammatory bowel disease is significantly less. However, with growing industrialisation it is likely that there will be an explosion of inflammatory bowel disease in some areas of Central and South America over the next 20 years. The creation of a network of researchers across South and Central America is a real possibility and through a Concerted Action there is the possibility that major strides could be made towards understanding the cause of inflammatory bowel disease and so develop preventive strategies.
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Affiliation(s)
- Affifa FARRUKH
- University Hospitals of Leicester NHS Trust, United Kingdom
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12
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Childers RE, Eluri S, Vazquez C, Weise RM, Bayless TM, Hutfless S. Family history of inflammatory bowel disease among patients with ulcerative colitis: a systematic review and meta-analysis. J Crohns Colitis 2014; 8:1480-97. [PMID: 24974207 DOI: 10.1016/j.crohns.2014.05.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/03/2014] [Accepted: 05/31/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Despite numerous shared susceptibility loci between Crohn's disease and ulcerative colitis, the prevalence of family history among ulcerative colitis patients is not well-established and considered to be less prevalent. A systemic review and meta-analysis were conducted to estimate the prevalence of family history of inflammatory bowel disease in ulcerative colitis patients, and its effect on disease outcomes. METHODS PubMED was searched to identify studies reporting the prevalence of family history of inflammatory bowel disease among ulcerative colitis patients. Definitions of family history, study type, and subtypes of family history prevalence were abstracted, as were disease outcomes including age at ulcerative colitis diagnosis, disease location, surgery and extraintestinal manifestations. Pooled prevalence estimates were calculated using random effects models. RESULTS Seventy-one studies (86,824 patients) were included. The prevalence of a family history of inflammatory bowel disease in ulcerative colitis patients was 12% (95% confidence interval [CI] 11 to 13%; range 0-39%). Family history of ulcerative colitis (9%; 22 studies) was more prevalent than Crohn's disease (2%; 18 studies). Patients younger than 18years of age at time of diagnosis had a greater family history of inflammatory bowel disease (prevalence 15%, 95% CI: 11-20%; 13 studies). There were no differences in disease location, need for surgery, or extraintestinal manifestations among those with a family history, although very few studies reported on these outcomes. CONCLUSIONS Overall, 12% of ulcerative colitis patients have a family history of inflammatory bowel disease, and were more likely to have a family history of ulcerative colitis than Crohn's disease. Pediatric-onset ulcerative colitis patients were more likely to have a family history of inflammatory bowel disease.
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Affiliation(s)
- Ryan E Childers
- Division of Gastroenterology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Swathi Eluri
- Department of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Christine Vazquez
- Division of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University, 600N Wolfe St, Baltimore, MD 21287, USA
| | | | - Theodore M Bayless
- Division of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University, 600N Wolfe St, Baltimore, MD 21287, USA
| | - Susan Hutfless
- Division of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University, 600N Wolfe St, Baltimore, MD 21287, USA
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13
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Yamamoto-Furusho JK, De-León-Rendón JL, Alvarez-León E, Valdivia-Eziquio M, Obil-Chavarría C, Vargas-Alarcón G. Association of the interleukin 15 (IL-15) gene polymorphisms with the risk of developing ulcerative colitis in Mexican individuals. Mol Biol Rep 2014; 41:2171-6. [PMID: 24415300 DOI: 10.1007/s11033-014-3067-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 01/04/2014] [Indexed: 02/08/2023]
Abstract
Interleukin 15 (IL-15) is a Th1-related cytokine that triggers inflammatory cell recruitment with implications for pathogenesis in ulcerative colitis. The IL-15 gene is located within a 35 kb region of the q28-31 locus of chromosome 4. In the present work, the role of IL-15 gene polymorphisms as susceptibility markers for UC was evaluated. Seven polymorphisms of IL-15 (rs3806798, rs10833, rs4956403, rs2254514, rs2857261, rs10519613, and rs1057972) were genotyped by 5' exonuclease TaqMan genotyping assays in a group of 199 Mexican patients with UC and 698 Mexican Mestizo healthy unrelated individuals. UC patients and healthy controls showed similar distribution of the rs3806798, rs10833, rs4956403, rs2857261, rs10519613, and rs1057972 polymorphisms. The rs2254514 polymorphism was significantly associated with decreased risk of UC as compared to controls under both dominant and additive models (OR 0.62, Pdom = 0.014 and OR 0.65, Padd = 0.02). The rs2254514 CC genotype was associated with young age at diagnosis <40 years (P = 0.03; OR 3.67). Five polymorphisms (rs1051613, rs2254514, rs2857261, rs1057972, and rs10833) were in strong linkage disequilibrium and were included in six haplotypes: H1 (ACAAC), H2 (CCGTC), H3 (CTAAT), H4 (CCAAT), H5 (CTAAC), and H6 (CCAAC). UC patients showed an increased frequency of the H6 haplotype (P = 0.005; OR 3.2) and a decreased frequency of the H5 haplotype (P = 0.031; OR 0.40). These results suggest that the IL-15 rs2254514 polymorphism might have an important role in the development of UC in the Mexican population. We were able to distinguish one risk and one protective uncommon haplotype for the development of UC.
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Affiliation(s)
- Jesus K Yamamoto-Furusho
- Inflammatory Bowel Disease Clinic, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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14
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Atheymen R, Affes H, Ksouda K, Mnif L, Sahnoun Z, Tahri N, Zeghal KM, Hammami S. Effets indésirables de la sulfasalazine : discussion de leur mécanisme et du rôle de la composante sulfamidée. Therapie 2013; 68:369-73. [DOI: 10.2515/therapie/2013064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/20/2013] [Indexed: 11/20/2022]
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15
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Petritsch W, Fuchs S, Berghold A, Bachmaier G, Högenauer C, Hauer AC, Weiglhofer U, Wenzl HH. Incidence of inflammatory bowel disease in the province of Styria, Austria, from 1997 to 2007: a population-based study. J Crohns Colitis 2013; 7:58-69. [PMID: 22542057 DOI: 10.1016/j.crohns.2012.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 03/14/2012] [Accepted: 03/15/2012] [Indexed: 12/17/2022]
Abstract
BACKGROUND The incidence of inflammatory bowel disease (IBD) varies widely between different countries. This large variation is also observed for the incidence of its main two forms, ulcerative colitis (UC) and Crohn's disease (CD). Controversy exists whether IBD incidence is increasing, especially in western countries. Currently no data are available for Austria. This study therefore aimed to evaluate for the first time the incidence of IBD over an eleven-year period in Styria, a province of Austria with a population of 1.2 million. METHODS All patients with an initial diagnosis of IBD between 1997 and 2007, who were Styrian residents, were eligible for this retrospective study. Data were acquired from electronically stored hospital discharge reports and individual reports by patients and physicians. According to population density Styria was divided into two rural and one urban area. RESULTS Throughout the study period 1527 patients with an initial diagnosis of IBD were identified. The average annual incidence was 6.7 (95% CI 6.2-7.1) per 100,000 persons per year for CD and 4.8 (95% CI 4.5-5.2) for UC. The average annual incidence increased significantly (p<0.01) for both diseases during the 11 year study period. Median age at initial diagnosis was 29 years (range 3-87) for CD and 39 years (range 3-94) for UC. At diagnosis, 8.5% of all IBD patients were <18 years of age. The incidence of both CD and UC was significantly higher in the urban area than in rural areas (CD: 8.8, 95% CI 7.8-9.8 versus 5.5, 95% CI 4.7-6.4 and 5.9, 95% CI 5.3-6.7; [p<0.001]; UC: 5.8, 95% CI 5.1-6.6 versus 4.0, 95% CI 3.4-4.7 and 4.7, 95% CI 4.1-5.4; [p=0.04]). CONCLUSION We observed an overall increase in the incidence of ulcerative colitis and Crohn's disease in a part of Austria during an eleven year period. IBD was more predominant in the largest urban area than in rural areas.
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Affiliation(s)
- W Petritsch
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Austria.
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16
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Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, Benchimol EI, Panaccione R, Ghosh S, Barkema HW, Kaplan GG. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012; 142:46-54.e42; quiz e30. [PMID: 22001864 DOI: 10.1053/j.gastro.2011.10.001] [Citation(s) in RCA: 3365] [Impact Index Per Article: 280.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Revised: 09/26/2011] [Accepted: 10/03/2011] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS We conducted a systematic review to determine changes in the worldwide incidence and prevalence of ulcerative colitis (UC) and Crohn's disease (CD) in different regions and with time. METHODS We performed a systematic literature search of MEDLINE (1950-2010; 8103 citations) and EMBASE (1980-2010; 4975 citations) to identify studies that were population based, included data that could be used to calculate incidence and prevalence, and reported separate data on UC and/or CD in full manuscripts (n = 260). We evaluated data from 167 studies from Europe (1930-2008), 52 studies from Asia and the Middle East (1950-2008), and 27 studies from North America (1920-2004). Maps were used to present worldwide differences in the incidence and prevalence of inflammatory bowel diseases (IBDs); time trends were determined using joinpoint regression. RESULTS The highest annual incidence of UC was 24.3 per 100,000 person-years in Europe, 6.3 per 100,000 person-years in Asia and the Middle East, and 19.2 per 100,000 person-years in North America. The highest annual incidence of CD was 12.7 per 100,000 person-years in Europe, 5.0 person-years in Asia and the Middle East, and 20.2 per 100,000 person-years in North America. The highest reported prevalence values for IBD were in Europe (UC, 505 per 100,000 persons; CD, 322 per 100,000 persons) and North America (UC, 249 per 100,000 persons; CD, 319 per 100,000 persons). In time-trend analyses, 75% of CD studies and 60% of UC studies had an increasing incidence of statistical significance (P < .05). CONCLUSIONS Although there are few epidemiologic data from developing countries, the incidence and prevalence of IBD are increasing with time and in different regions around the world, indicating its emergence as a global disease.
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Inflammatory Bowel Disease in Hispanics: The University of Puerto Rico IBD Registry. Int J Inflam 2011; 2012:574079. [PMID: 22195289 PMCID: PMC3238376 DOI: 10.1155/2012/574079] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 10/29/2011] [Accepted: 11/07/2011] [Indexed: 12/30/2022] Open
Abstract
A registry of patients with inflammatory bowel
diseases, ulcerative colitis (UC) and Crohn's
disease (CD), was created at the University of
Puerto Rico in 1995. Subjects with a documented
diagnosis of IBD by clinical, radiologic,
endoscopic, and/or pathologic criteria were
recruited from the IBD clinics, support groups, and
community practices, and demographic and medical
data was collected. All entries from 1995 to 2009
were analyzed for demographics, family history,
disease extent, extraintestinal manifestations,
surgery, and smoking history. Results were
described using summary statistics. 635 Hispanics
living in Puerto Rico, 299 with UC and 336 with CD,
were included. Mean ages were 40.3 for UC and 30.9
for CD. Over half (56%) of UC and 41% of
CD were females. Family history was present in
19.3% of UC and 17.5% of CD. Surgery for
IBD had been performed in 31.9% of UC and
51.2% of the CD patients. Over one-fourth of
the patients reported extraintestinal
manifestations, most frequently arthropathies. Our
findings contribute to the limited epidemiologic
and clinical data on Hispanics with IBD.
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Smoking and inflammatory bowel diseases: what in smoking alters the course? Int J Colorectal Dis 2010; 25:671-80. [PMID: 20333390 DOI: 10.1007/s00384-010-0925-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2010] [Indexed: 02/08/2023]
Abstract
Epidemiological studies provide strong evidence to confirm the correlation between cigarette smoking and inflammatory bowel diseases. This relationship is proved to be positive in Crohn's disease and negative in ulcerative colitis. What in smoking alters the course of inflammatory bowel diseases is still a mystery. Different smoking parts have different and may be opponent actions. Smoking has dual effects. Some of its activities are, sometimes, constructive as they are working in an antagonistic manner to the mechanism of the disease, such as reducing rectal blood flow and accordingly less recruitments of inflammatory mediators to the area of inflammation, enhancement of mucosal production, and consequently, strengthening the membranes, and inhibition of pro-inflammatory mediators' liberation and activity in subjects with ulcerative colitis. Yet the outcome of smoking actions may be affected by the existence of other cofactors. Odd factors, such as shortage of zinc in subjects with Crohn's disease, may facilitate liberation of pro-inflammatory mediators and their activities and accordingly exacerbates symptoms.
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Clinical epidemiology of ulcerative colitis in Mexico: a single hospital-based study in a 20-year period (1987-2006). J Clin Gastroenterol 2009; 43:221-4. [PMID: 19057395 DOI: 10.1097/mcg.0b013e31817a76b4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Ulcerative colitis (UC) is a chronic disease with a heterogeneous clinical evolution. The prevalence and incidence of UC vary widely and depend on multiple factors including ethnicity and geographic location. GOAL To determine the frequency of new cases of UC and their clinical characteristics in a large cohort from a referral hospital in Mexico City. STUDY Patients with confirmed diagnosis of UC were included during a period between January 1987 and December 2006. Demographic and clinical data were collected from medical records. RESULTS A total of 848 new cases of UC were diagnosed during a 20-year period. All the patients had endoscopic and histologic confirmation. The mean of annual new UC cases increased from 28.8 in the first period (1987 to 1996) to 76.1 in the second period (1997 to 2006) (P<0.00008). The incidence of new cases increased 2.6-fold comparing both periods of time. This study consisted of 467 females and 382 males, with a mean age at diagnosis of 31.3+/-12.3 years. The clinical manifestations were pancolitis (59.1%), and extraintestinal manifestations (41.5%). Most of the patients, 762 (89.8%) were taking sulfasalazine or 5-aminosalicylic acid, 282 (33.3%) used oral or systemic steroids, 237 (28%) were taking azathioprine. CONCLUSIONS The frequency of new UC cases has increased significantly in the last 10 years in Mexico, largely due to the unique genetic make-up and the environmental factors (infectious diseases including parasites) not found in other countries.
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Gismera CS, Aladrén BS. Inflammatory bowel diseases: A disease (s) of modern times? Is incidence still increasing? World J Gastroenterol 2008; 14:5491-8. [PMID: 18810764 PMCID: PMC2746333 DOI: 10.3748/wjg.14.5491] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBD) are a heterogeneous group of diseases, not always easy to diagnose, even more difficult to classify, and diagnostic criteria are not always uniform. Well done population-based studies are not abundant, and so comparisons among different geographical areas or populations are not always very reliable. In this article, we have reviewed epidemiological studies available on the world’s population while making a critical review of published data.
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Economou M, Pappas G. New global map of Crohn's disease: Genetic, environmental, and socioeconomic correlations. Inflamm Bowel Dis 2008; 14:709-20. [PMID: 18095316 DOI: 10.1002/ibd.20352] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Seventy-five years after the initial characterization of Crohn's disease (CD), much remains obscure about its etiology. The authors sought to evaluate the incidence trends of the last 25 years worldwide, and the existence of potential correlations with genetic, environmental, and socioeconomic factors that could be etiologically implicated in the pathogenesis of CD. Relevant medical literature for individual countries on the incidence of CD, on the incidence of associated genetic mutations, and on the incidence of suggested etiologic infectious agents such as Mycobacterium avium paratuberculosis were retrieved from published medical literature, reports from relevant international congresses, and through official reports from national health authorities. Increasing trends have been observed almost worldwide, with a broad north-south gradient still prevailing in Europe. Distinct regions of New Zealand, Canada, Scotland, France, the Netherlands, and Scandinavia represent the highest incidence areas. Industrialized status and affluence are the common denominators between endemic areas, but are too broad as terms to strongly indicate any particular etiological role. The increasing trends observed in Asia still account for a low prevalence of the disease and may represent increased detection and diagnostic ability of local health systems. Genetic associations are variably reproduced worldwide, in a manner inconsistent with a strong etiologic relationship. Data on paratuberculosis incidence are scarce, and the existing ones are ambivalent regarding an even indirect correlation between CD and an infectious trigger.
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