Crohn's disease in Bangladeshis and Europeans in Britain: an epidemiological comparison in Tower Hamlets

Probert, Chris; Venkataraman, Jayanthi; Pollock, D. J.; Baithun, Suhail; Mayberry, J F; Rampton, David

doi:10.1136/pgmj.68.805.914

Cited by 22 publications

(27 citation statements)

References 26 publications

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“…Northern Indians, particularly from Punjab, have been shown to have a very high incidence of UC. This is supported by a study on a migrant population in Leicester which showed the highest incidence of UC amongst Sikhs (from Punjab) 27 …”

Section: Introductionmentioning

confidence: 67%

“…The incidence rates of UC and CD, expressed in 100 000 person-years and the prevalence rates expressed per 100 000 population in Asians and Western patients (selected population groups) are as shown for comparison in Tables 1 and 2. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] In the absence of an IBD registry, population statistics have been difficult to obtain. Many studies are hospitalbased studies of endoscopically and histologically confirmed cases of IBD extrapolated to the area that is served by the hospital, using the population of the area concerned as the denominator.…”

Section: Incidence and Prevalence Datamentioning

confidence: 99%

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Inflammatory bowel disease: A survey of the epidemiology in Asia

Goh¹,

Xiao²

2009

J of Digest Diseases

113

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Inflammatory bowel disease (IBD) has long been considered a disease that affects predominantly a Western population. The incidence and prevalence rates from Asian populations are much lower in comparison. More recent data, however, have shown significantly higher rates in Asians and time trend studies have shown an increase in the incidence of ulcerative colitis (UC) and a similar but lower rise in Crohn's disease (CD). The epidemiological changes that are taking place mirror that of the Western experience seen 50 years previously and seem to occur in parallel with the rapid socioeconomic development taking place in Asia. It appears that certain racial groups are more prone than others to develop IBD. For instance, Indians in South‐East Asia have higher rates compared to Chinese and Malays. While there is host genetic predisposition, environmental factor(s) may be responsible for this difference. Migrant studies of South Asians in the UK, where second‐generation immigrants have assumed incidence rates as high as the indigenous whites and Asian Jews who develop high incidence rates comparable to Jews from Europe or North America in Israel point to the role of environmental factors. It is unclear which specific factors are responsible. Studies have suggested a change in diet to a more Westernized one may underlie this epidemiological change in the Asian population. It is likely that there are racial groups amongst Asians who are more susceptible to IBD and who will demonstrate a higher frequency of IBD when exposed to putative environmental factors.

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Section: Introductionmentioning

confidence: 67%

Section: Incidence and Prevalence Datamentioning

confidence: 99%

Inflammatory bowel disease: A survey of the epidemiology in Asia

Goh¹,

Xiao²

2009

J of Digest Diseases

113

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“…Asian immigrants to the West. A number of studies related to IBD in South Asian immigrants to the United Kingdom (UK) were published in the 1990s 5–7,36–38 . Incidence and prevalence data from Leicestershire reported a higher incidence of UC, but an equal or lower incidence of CD, in individuals of South Asian compared to European ethnicity 5–7 .…”

mentioning

confidence: 99%

Inflammatory bowel disease in Asia: A systematic review

Prideaux

Kamm

Cruz

et al. 2012

J of Gastro and Hepatol

304

249

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The incidence and prevalence of inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), are lower in Asia than in the West. However, across Asia the incidence and prevalence of IBD has increased rapidly over the last two to four decades. These changes may relate to increased contact with the West, westernization of diet, increasing antibiotics use, improved hygiene, vaccinations, or changes in the gut microbiota. Genetic factors also differ between Asians and the Caucasians. In Asia, UC is more prevalent than CD, although CD incidence is rapidly increasing in certain areas. There is a male predominance of CD in Asia, but a trend towards equal sex distribution for UC. IBD is diagnosed at a slightly older age than in the West, and there is rarely a second incidence peak as in the West. A positive family history is much less common than in the West, as are extra-intestinal disease manifestations. There are clear ethnic differences in incidence within countries in Asia, and an increased incidence in IBD in migrants from Asia to the West. Research in Asia, an area of rapidly changing IBD epidemiology, may lead to the discovery of critical etiologic factors that lead to the development of IBD.

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“…• The children of migrants from low IBD incidence regions to high IBD incidence regions may develop IBD at similar rates to those whose families have always lived in the high incidence regions [23,24] .…”

Section: Differences In Worldwide Ibd Descriptive Epidemiologymentioning

confidence: 99%

IBD and Environment: Are There Differences between East and West

Gearry

2016

Dig Dis

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Background: The inflammatory bowel diseases (IBDs), Crohn's disease (CD) and ulcerative colitis (UC) occur worldwide with differences in epidemiology, etiology and phenotype between regions. Breakthroughs have occurred in IBD genetics, although the genes that predispose to IBD differ between racial groups. What do we know about the ‘envirotype' of those who develop IBD, and are there differences between the East and the West? Key Messages: The strongest IBD risk factor identified to date is a family history of IBD. Whilst likely representing an underlying genetic predisposition, it may also reflect shared environmental factors amongst family members. Cigarette smoking increases the risk of developing CD, whilst smoking is less common in those who develop UC. Having ceased smoking increases the risk of developing UC subsequently. Unlike the West, cigarette smoking appears to play a lesser role in the East. Other environmental risk factors are inconsistent. Studies of migrant populations moving from regions of low to high IBD incidence point to early life as a key time for environmental triggers. In these populations, it is the second generation (those born in the high incidence region) with higher IBD incidence rates than their parents. Early life environmental exposures have been studied exhaustively but, except for having been breastfed, few putative early childhood environmental risk factors have been shown consistently to alter the risk of developing IBD. Conclusions: The identification of IBD environmental risk factors remains elusive in both the East and West. In the West, case-control studies are unlikely to move the field forward without multi-level (phenotype, genotype, diet history, ‘envirotype' and microbiome) data, ideally collected prospectively. Cohort studies (such as the Genes, Environment, Microbiome project) may address some of these issues. However, in the East where IBD incidence is still increasing, well-designed comprehensive case-control studies may identify differences that give an insight into the ‘envirotype' driving IBD incidence.

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Crohn's disease in Bangladeshis and Europeans in Britain: an epidemiological comparison in Tower Hamlets

Cited by 22 publications

References 26 publications

Inflammatory bowel disease: A survey of the epidemiology in Asia

Inflammatory bowel disease: A survey of the epidemiology in Asia

Inflammatory bowel disease in Asia: A systematic review

IBD and Environment: Are There Differences between East and West

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