Sex-Related Differences in Patients With Inflammatory Bowel Disease: Results of 2 Prospective Cohort Studies

Severs, Mirjam; Spekhorst, Lieke M.; Mangen, Marie-Josée J.; Dijkstra, Gerard; Löwenberg, Mark; Hoentjen, Frank; Jong, Andrea E. van der Meulen–de; Pierik, Marieke; Ponsioen, Cyriel Y.; Bouma, Gerd; Woude, C. Janneke van der; Valk, Mirthe E. van der; Romberg‐Camps, Mariëlle; Clemens, Cees H.; Meeberg, Paul van de; Mahmmod, Nofel; Jansen, Jeroen M.; Jharap, Bindia; Weersma, Rinse K.; Oldenburg, Bas; Festen, Eleonora A. M.; Fidder, Herma H.

doi:10.1093/ibd/izy004

Cited by 73 publications

(80 citation statements)

References 28 publications

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“…They were more often diagnosed with ileal disease and they underwent more often small bowel and ileocaecal resection. 32 In our cohort, rates of previous resection between men and women were similar.…”

Section: Discussionsupporting

confidence: 49%

Male gender, active smoking and previous intestinal resection are risk factors for post‐operative endoscopic recurrence in Crohn's disease: results from a prospective cohort study

Auzolle

Nancey

Tran‐Minh

et al. 2018

Aliment Pharmacol Ther

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Summary Background After ileocaecal resection for Crohn's disease (CD), inflammatory lesions frequently recur on the anastomosis and/or on the neo‐terminal ileum. Aim To identify predictors of early post‐operative endoscopic recurrence. Methods From September 2010 to September 2017, the REMIND group conducted a prospective nationwide study in nine French academic centres. Data were collected at the time of surgery and endoscopy, performed 6‐12 months after surgery. Endoscopic recurrence was defined as a Rutgeerts score ≥i2. Baseline factors associated with endoscopic recurrence were searched by univariate and multivariate regression analysis. Results Two hundred and eighty‐nine CD patients were included. Endoscopy within 1 year following surgery was performed in 225 (78%) patients (104M/121F). Mean age and disease duration were 35 (12.2) and 8.8 (8.9) years respectively. Seventy (32%) patients were active smokers at surgery. One hundred and forty‐two (63%) patients received at least one anti‐TNF therapy before surgery. After surgery, 40 (18%) patients received thiopurines and 66 (29%) received an anti‐TNF agent. Endoscopic recurrence occurred in 107 (47%) patients. In multivariate analysis, male gender (OR = 2.48 [IC 95% 1.40‐4.46]), active smoking at surgery (OR = 2.65 [IC 95% 1.44‐4.97]) and previous resection (OR = 3.03 [IC 95% 1.36‐7.12]) were associated with a higher risk of endoscopic recurrence. Inversely, post‐operative anti‐TNF treatment decreased the risk of endoscopic recurrence (OR = 0.50 [IC 95% 0.25‐0.96]). Conclusions Male gender, active smoking at surgery and previous intestinal resection are associated with a higher risk of endoscopic post‐operative recurrence, while post‐operative anti‐TNF treatment is associated with a lower risk.

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Section: Discussionsupporting

confidence: 49%

Male gender, active smoking and previous intestinal resection are risk factors for post‐operative endoscopic recurrence in Crohn's disease: results from a prospective cohort study

Auzolle

Nancey

Tran‐Minh

et al. 2018

Aliment Pharmacol Ther

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“…Data regarding sex differences in the incidence, disease severity, response to medications, and mortality of IBD patients are limited and inconclusive (45,46). However, the presence of sex differences in IBD in patients is indicated by several lines of evidence.…”

Section: Discussionmentioning

confidence: 99%

Dietary Chitin Particles Called Mimetic Fungi Ameliorate Colitis in Toll-Like Receptor 2/CD14- and Sex-Dependent Manners

Louis

Mercer

et al. 2019

Infect Immun

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Chitin is a natural N-acetylglucosamine polymer and a major structural component of fungal cell walls. Dietary chitin is mucoadhesive; anti-inflammatory effects of chitin microparticles (CMPs; 1- to 10-μm diameters) have been demonstrated in models of inflammatory bowel disease (IBD). The goals of this study were to assess (i) whether CMPs among various chitin preparations are the most effective against colitis in male and female mice and (ii) whether host chitin-binding Toll-like receptor 2 (TLR2) and CD14 are required for the anti-inflammatory effect of chitin. We found that colitis in male mice was ameliorated by CMPs and large chitin beads (LCBs; 40 to 70 μm) but not by chitosan (deacetylated chitin) microparticles, oligosaccharide chitin, or glucosamine. In fact, LCBs were more effective than CMPs. In female colitis, on the other hand, CMPs and LCBs were equally and highly effective. Neither sex of TLR2-deficient mice showed anti-inflammatory effects when treated with LCBs. No anti-inflammatory effect of LCBs was seen in either CD14-deficient males or females. Furthermore, an in vitro study indicated that when LCBs and CMPs were digested with stomach acidic mammalian chitinase (AMC), their size-dependent macrophage activations were modified, at least in part, suggesting reduced particle sizes of dietary chitin in the stomach. Interestingly, stomach AMC activity was greater in males than females. Our results indicated that dietary LCBs were the most effective preparation for treating colitis in both sexes; these anti-inflammatory effects of LCBs were dependent on host TLR2 and CD14.

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“…The reported rate of 51.7% is higher than that seen in male counterparts as well as in the ageand sex-matched general population (26.6%) [24]. Accordingly, a Dutch study revealed that more women than men are current smokers in the IBD population [17]. Long time ago, the following dogma was established and has been supported since: smoking is protective in UC, while it has deleterious effects in CD patients.…”

Section: Environmental Factorsmentioning

confidence: 99%

“…In Europe and the United States, CD prevalence appears to be higher in females than in males [8][9][10][11][12][13], while in Asia the opposite has been observed [14][15][16]. Early-onset CD (< 16 years) has been reported to be more frequent in males than females (20 vs. 12%) [17]. A recent large investigation revealed an even more complex relation between sex and IBD epidemiology [18].…”

Section: Epidemiologymentioning

confidence: 99%

Gender Differences in Inflammatory Bowel Disease

et al. 2020

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Sex-Related Differences in Patients With Inflammatory Bowel Disease: Results of 2 Prospective Cohort Studies

Abstract: Sex differences in patients with IBD include age of onset, disease location, and EIM prevalence. No large differences in therapeutic management of IBD were observed between men and women with IBD. 10.1093/ibd/izy004_video1izy004_Video_15786481854001.

Cited by 73 publications

References 28 publications

Male gender, active smoking and previous intestinal resection are risk factors for post‐operative endoscopic recurrence in Crohn's disease: results from a prospective cohort study

Male gender, active smoking and previous intestinal resection are risk factors for post‐operative endoscopic recurrence in Crohn's disease: results from a prospective cohort study

Dietary Chitin Particles Called Mimetic Fungi Ameliorate Colitis in Toll-Like Receptor 2/CD14- and Sex-Dependent Manners

Gender Differences in Inflammatory Bowel Disease

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