Second peak in the distribution of age at onset of ulcerative colitis in relation to smoking cessation

Takahashi, Hidemi; Matsui, Toshiyuki; Hisabe, Takashi; Hirai, Fumihito; Takatsu, Noritaka; Tsurumi, Kozue; Kanemitsu, Takao; Sato, Yuho; Kinjyo, Ken; Yano, Yutaka; Takaki, Yasuhiro; Nishizaki, Takashi; Yao, Kenshi; Washio, Masakazu

doi:10.1111/jgh.12616

Cited by 34 publications

(30 citation statements)

References 30 publications

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“…The incidence of UC shows a bimodal distribution in the age at onset[ 48 - 51 ], and the second peak of incidence in the elderly is closely related to the environmental etiologies of UC. Surprisingly, the age-specific incidence of UC is in a steady state between the ages of the 20 s to 60 s with the highest rates for men in their 60 s in a recent 30-year follow-up epidemiological study from South Korea[ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Kang

Chun

Kim

et al. 2020

WJG

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BACKGROUND Periodontitis is a chronic inflammation of periodontal tissues. The effect of periodontitis on the development of inflammatory bowel disease (IBD) remains unclear. AIM To assessed the risk of IBD among patients with periodontitis, and the risk factors for IBD related to periodontitis. METHODS A nationwide population-based cohort study was performed using claims data from the Korean National Healthcare Insurance Service. In total, 9950548 individuals aged ≥ 20 years who underwent national health screening in 2009 were included. Newly diagnosed IBD [Crohn’s disease (CD), ulcerative colitis (UC)] using the International Classification of Disease 10 th revision and rare intractable disease codes, was compared between the periodontitis and non-periodontitis groups until 2017. RESULTS A total of 1092825 individuals (11.0%) had periodontitis. Periodontitis was significantly associated with older age, male gender, higher body mass index, quitting smoking, not drinking alcohol, and regular exercise. The mean age was 51.4 ± 12.9 years in the periodontitis group and 46.6 ± 14.2 years in the non-periodontitis group ( P < 0.01), respectively. The mean body mass index was 23.9 ± 3.1 and 23.7 ± 3.2 in the periodontitis and non-periodontitis groups, respectively ( P < 0.01). Men were 604307 (55.3%) and 4844383 (54.7%) in the periodontitis and non-periodontitis groups, respectively. The mean follow-up duration was 7.26 years. Individuals with periodontitis had a significantly higher risk of UC than those without periodontitis [adjusted hazard ratio: 1.091; 95% confidence interval (CI): 1.008-1.182], but not CD (adjusted hazard ratio: 0.879; 95% confidence interval: 0.731-1.057). The risks for UC were significant in the subgroups of age ≥ 65 years, male gender, alcohol drinker, current smoker, and reduced physical activity. Current smokers aged ≥ 65 years with periodontitis were at a 1.9-fold increased risk of UC than non-smokers aged ≥ 65 years without periodontitis. CONCLUSION Periodontitis was significantly associated with the risk of developing UC, but not CD, particularly in current smokers aged ≥ 65 years.

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Section: Discussionmentioning

confidence: 99%

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Kang

Chun

Kim

et al. 2020

WJG

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“…26,27 In contrast to findings in West, a bimodal distribution was only seen in CD and not in UC in most Asian populations, where the incidence rate of CD peaked in the age ranges of 20-24 years and 40-44 years. 13 However, a recent review suggested that there is an increase in elderly onset UC in the Japanese population, likewise, a questionnaire-based single-center study in Japan suggested a bimodal distribution of UC with incidence rate peaking at 10-20 years followed by smaller peaks at 40-44 years and 50-60 years 31,32 . These findings remain to be replicated in population-based cohorts.…”

Section: Clinical Features Of Ibdmentioning

confidence: 99%

The epidemiology of inflammatory bowel disease: East meets west

Mak

Zhao

et al. 2019

J of Gastro and Hepatol

448

291

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The incidence of inflammatory bowel diseases (IBD) in East has risen over the past decade to become a global disease. The increasing number of studies on the incidence and course of IBD in East has enabled us to explore East versus West differences in the epidemiology of IBD which could enhance our understanding of the heterogeneity of the disease and eventually assist in the discovery of novel therapeutic targets and design of preventive strategies. Comparison of population‐based data in East and West reveals that the incidence of IBD has risen rapidly in East while plateauing in West. Furthermore, the clinical presentation and course of IBD differs between East and West with more patients in East presenting with complicated disease. Considering the scarcity of population‐based data from East and the lack of studies with long durations of follow‐up, it remains to be clarified whether these differences reflect true differences in disease presentation. The effects of genetic and environmental risk factors contributing to IBD also differ between Eastern and Western populations. Considering the differential effects of genetic and environmental risk factors in East and West, future studies should seek to discover novel genetic and environmental risk factors which might specifically apply to eastern populations. In this narrative review, we compare the epidemiology of IBD between eastern and western countries by summarizing evidence from population‐based cohort studies in the last ten years. Furthermore, we look at differences in genetic susceptibility and environmental triggers of IBD between East and West.

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“…They found that the ratio of EOUC patients increased from 6.3% in those diagnosed before 2000 to 25.9% in those diagnosed after 2001. They also determined that the average age at UC onset was increasing and that a second peak in bimodal distribution of onset shifted to older age [30]. Song et al reported that the percentage of elderly patients among newly diagnosed patients had increased from 3.9% in 1977–1999 to 9.7% in 2008–2014 [31].…”

Section: Diagnosis and Epidemiology In Elderly Uc Patientsmentioning

confidence: 99%

“…Song et al reported that the percentage of elderly patients among newly diagnosed patients had increased from 3.9% in 1977–1999 to 9.7% in 2008–2014 [31]. Although the cause the increasing incidence of EOUC in several regions and ethnicities remains unclear, Takahashi et al reported that past smoking habit is a possible risk factor (OR 2.93) for elderly-onset UC [30]. Araki et al reported that more than half of the IBD patients (51.1%) experienced seasonal exacerbation of IBD, and winter was the most common season for disease exacerbation.…”

Section: Diagnosis and Epidemiology In Elderly Uc Patientsmentioning

confidence: 99%

Management of elderly ulcerative colitis in Japan

et al. 2019

Self Cite

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Japan has the largest aging society, where many elderly people have intractable diseases including ulcerative colitis (UC). Along with the increasing total number of UC patients, the number of elderly UC patients has also been increasing and will continue to do so in the future. Although the clinical features and natural history of UC in the elderly have many similarities with UC in the non-elderly population, age-specific concerns including comorbidities, immunological dysfunction, and polypharmacy make the diagnosis and management of elderly UC challenging compared to UC in non-elderly patients. Based on increasing data related to elderly UC patients from Japan, as well as other countries, we reviewed the epidemiology, clinical course, differential diagnosis, management of comorbidities, surveillance, medical therapy, and surgery of UC in the elderly.

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Second peak in the distribution of age at onset of ulcerative colitis in relation to smoking cessation

Abstract: Similar to UC patients in Western countries, a bimodal distribution of onset age was also observed in Japanese UC patients, and smoking cessation may partly contribute to the increase in late-onset UC patients in recent years in Japan.

Cited by 34 publications

References 30 publications

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study

The epidemiology of inflammatory bowel disease: East meets west

Management of elderly ulcerative colitis in Japan

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