Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries

Shah, Shailja C.; Khalili, Hamed; Gower‐Rousseau, Corinne; Olén, Ola; Benchimol, Eric I; Lynge, Elsebeth; Nielsen, K R; Brassard, Paul; Vutcovici, Maria; Bitton, Alain; Bernstein, Çharles N.; Leddin, Desmond; Tamim, Hani; Stefánsson, Tryggvi; Loftus, Edward V.; Moum, Bjørn; Tang, Whitney; Ng, Siew C.; Gearry, Richard B.; Sinčić, Brankica Mijandrušić; Bell, Sally; Sands, Bruce E.; Lakatos, László; Végh, Zsuzsanna; Ott, Claudia; Kaplan, Gilaad G.; Burisch, Johan; Colombel, Jean Fréd́eric

doi:10.1053/j.gastro.2018.06.043

Cited by 211 publications

(144 citation statements)

References 89 publications

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“…In this respect, our results are in agreement with other studies that have demonstrated that the presenting phenotype of childhood‐onset IBD is characterised by extensive anatomic involvement, in comparison with adulthood‐onset IBD . In addition, in agreement with a recent study published by Shah et al, the proportion of male sex was higher in the childhood‐onset cohort . Second, family history of IBD was more frequent in childhood‐onset IBD, suggesting a higher genetic load in this group of patients.…”

Section: Discussionsupporting

confidence: 93%

“…24 In addition, in agreement with a recent study published by Shah et al, the proportion of male sex was higher in the childhood-onset cohort. 25 Second, family history of IBD was more frequent in childhood-onset IBD, suggesting a higher genetic load in this group of patients. Third, the use of immunomodulators and biologic agentsafter adjusting by relevant variables such as the type of IBD, sex, tobacco use or family history of IBD-was higher among childhoodonset IBD patients.…”

Section: Discussionmentioning

confidence: 83%

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Differences between childhood‐ and adulthood‐onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Chaparro

Garre

Ricart

et al. 2019

Aliment Pharmacol Ther

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Summary Background Cohort studies comparing the characteristics of childhood‐onset and adulthood‐onset inflammatory bowel disease (IBD) in the biologics era are scarce. Aim To compare disease characteristics, the use of immunomodulators and biologic agents and the need for surgery between childhood‐ and adulthood‐onset IBD. Methods Inflammatory bowel disease patients from the ENEIDA registry diagnosed between 2007 and 2017 were included. The childhood‐onset cohort comprised patients diagnosed at ≤16 years of age and the adulthood‐onset cohort those diagnosed at >16 years. The cumulative incidences of immunosuppressive therapy, biologic therapy and surgery were estimated using Kaplan‐Meier curves, compared by the log‐rank test. Cox regression analysis was performed to identify potential predictive factors of treatment with immunosuppressants, biologic agents or surgery. Results The adulthood‐onset cohort comprised 21 200 patients out of 20 354 (96%) and the childhood‐onset cohort 846 (4%). Median follow‐up was 54 months in the childhood‐onset cohort and 38 months in the adulthood‐onset cohort (P < 0.01). Proportions of Crohn's disease, ileocolonic involvement and inflammatory behaviour at diagnosis were higher in the childhood‐onset cohort. In the multivariate analysis, after adjusting for sex, type of IBD, extraintestinal manifestations, family history and smoking habit, childhood‐onset IBD was associated with higher risk of immunomodulator use (hazard ratio [HR] = 1.2, 95% confidence interval [95% CI] = 1.1‐1.2) and higher probability of receiving biologic treatment (HR = 1.2, 95% CI = 1.1‐1.3). However, childhood‐onset IBD was not associated with higher risk of surgery (HR = 0.9, 95% CI = 0.8‐1.2). Conclusions Childhood‐onset IBD has differential characteristics and higher risk of treatment with immunomodulators and biologic agents, compared with adulthood‐onset IBD. Nevertheless, paediatric IBD is not associated with higher risk of surgery.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 83%

Differences between childhood‐ and adulthood‐onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Chaparro

Garre

Ricart

et al. 2019

Aliment Pharmacol Ther

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“…Women showed higher global prevalence than men accordingly with previous findings concerning incidence . There was, however, heterogeneity across geographic areas.…”

Section: Discussionsupporting

confidence: 76%

Inflammatory bowel disease: estimates from the global burden of disease 2017 study

Piovani

Danese

Peyrin–Biroulet

et al. 2019

Aliment Pharmacol Ther

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Summary Background Inflammatory bowel disease (IBD) is a significant health problem in the industrialised world, currently increasing in developing countries. Understanding the global burden of IBD is important to tackle increasing disease occurrence. Aim To investigate the GBD (Global Burden of Disease) 2017 Study Database summarising and critically evaluating the global burden of IBD Methods We presented age‐standardised prevalence estimates, disability‐adjusted life years (DALYs) and its components: years lived with disability (YLDs) and years of life lost (YLLs) due to premature mortality. We reported these measures from 1990 to 2017 and stratified by region, socio‐demographic index (SDI), gender and age group. Results The latest IBD prevalence and burden estimates varied widely across regions, and were particularly elevated in high‐SDI countries. Despite an increasing prevalence from 1990 to 2017 (+6%), the IBD burden decreased (DALYs −12%). This decrease was driven by IBD‐associated premature mortality (YLLs −26%). This measure represented a high share of disease burden in low‐SDI countries (86% of DALYs), whereas disability constituted the predominant component in high‐SDI countries (71%) in 2017. Disease burden decreased particularly in children (DALYs −39% and YLLs −52%). In the last 10 years, however, prevalence plateaued in middle‐ to high‐SDI countries and steeply increased in low‐SDI countries. Conclusions These findings highlight significant improvements in IBD care in the last three decades, particularly in children. The global burden of IBD and premature mortality have progressively decreased. The increase in disease frequency observed in developing countries is worrying, especially considering the high associated premature mortality in these areas.

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“…3,11,[28][29][30] In a pooled analysis of studies in the West, females predominated among CD patients from adolescence to middle-age, while a higher risk of UC was found among males aged 45 years and older. 33 These findings contrast with those from Asia, where male gender was associated with a higher risk of both CD and UC. In mainland China, the risk ratio of CD and UC in males versus females is 1.15:1 and 2.4:1, respectively.…”

Section: Clinical Features Of Ibdmentioning

confidence: 87%

“…In CD, less consistent findings have been reported, with some cohorts suggesting a female predominance in the incidence of CD and others failing to find any gender difference whatsoever . In a pooled analysis of studies in the West, females predominated among CD patients from adolescence to middle‐age, while a higher risk of UC was found among males aged 45 years and older …”

Section: Clinical Features Of Ibdmentioning

confidence: 94%

The epidemiology of inflammatory bowel disease: East meets west

Mak

Zhao

et al. 2019

J of Gastro and Hepatol

Self Cite

445

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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Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries

Abstract: 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.

Cited by 211 publications

References 89 publications

Differences between childhood‐ and adulthood‐onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Differences between childhood‐ and adulthood‐onset inflammatory bowel disease: the CAROUSEL study from GETECCU

Inflammatory bowel disease: estimates from the global burden of disease 2017 study

The epidemiology of inflammatory bowel disease: East meets west

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