Incidence and Phenotype of Inflammatory Bowel Disease Based on Results From the Asia-Pacific Crohn's and Colitis Epidemiology Study
Incidence and Phenotype of Inflammatory Bowel Disease Based on Results From the Asia-Pacific Crohn's and Colitis Epidemiology Study
复制标题
DOI：
10.1053/j.gastro.2013.04.007
复制
发表时间：
2013-07-01
期刊：
影响因子：
29.4
通讯作者：
Chan, Francis K. L.
中科院分区：
文献类型：
--
作者：
Ng, Siew C.;Tang, Whitney;Chan, Francis K. L.
背景与目的：炎症性肠病（IBD）在亚洲越来越常见，但缺乏流行病学数据。亚太克罗恩病和结肠炎流行病学研究旨在确定亚洲8个国家和澳大利亚IBD的发病率和表型。方法：我们在预定的集水区进行了一项前瞻性、基于人群的IBD发病率研究，从2011年4月1日开始收集1年的数据。从多个相互重叠的来源查明了新的病例，并将其输入一个网络数据库。使用标准标准确认病例。检索当地内镜检查、病理学和药房记录，以确保病例采集的完整性。结果：我们确定了419例IBD新发病例（232例溃疡性结肠炎[UC]，166例克罗恩病[CD]，21例IBD未确定）。亚洲IBD的粗年总发病率值为1.37/100，000人（95%置信区间：1.25-1.51; UC为0.76，CD为0.54，IBD为0.07-未确定），澳大利亚为23.67（95%置信区间：18.46-29.85; UC为7.33，CD为14.00，IBD为2.33-未确定）。中国是亚洲IBD发病率最高的国家（3.44/10万）。UC与CD的比值在亚洲为2.0，在澳大利亚为0.5。从症状发作到诊断的中位时间为5.5个月（四分位距，1.4-15个月）。复杂性CD（狭窄性、穿透性或肛周疾病）在亚洲比澳大利亚更常见（52%比24%; P = 0.001），IBD家族史在亚洲较不常见（3%比17%; P <0.001）。结论：我们进行了一项大规模的基于人群的研究，发现尽管IBD的发病率在整个亚洲各不相同，但仍低于西方。IBD在亚洲可能与西方一样严重或更严重。IBD在亚洲的出现将导致对特定卫生保健资源的需求，并为研究发展中国家的病因因素提供了独特的机会。
BACKGROUND & AIMS: Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. METHODS: We performed a prospective, population-based study of IBD incidence in pre-defined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. RESULTS: We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001). CONCLUSIONS: We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.