A nationwide cohort study of the incidence of inflammatory bowel disease in Sweden from 1990 to 2014
A nationwide cohort study of the incidence of inflammatory bowel disease in Sweden from 1990 to 2014
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DOI：
10.1111/apt.16735
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发表时间：
2021-12-14
影响因子：
7.6
通讯作者：
Ludvigsson, Jonas F.
中科院分区：
文献类型：
--
作者：
Forss, Anders;Clements, Mark;Ludvigsson, Jonas F.
流行病学研究表明，炎症性肠病（IBD）的发病率（IRs）不一致。目的评估瑞典IBD的发病率和时间趋势。方法基于1990-2014年ESPRESSO队列登记的IBD诊断代码和活检报告进行全国队列研究。计算年龄特异性和年龄标准化的ir和累积发病率。总体而言，我们确定了65908例IBD事件：溃疡性结肠炎（UC, n = 38 261, 58%），克罗恩病（CD, n = 18 577, 28%）和IBD- u （n = 9070, 14%）。在1990-2014年期间，IBD的总体IR为每10万人年29.0 (95% CI: 27.3-30.7)， UC为16.9 (15.9-17.9)，CD为8.1（7.7-8.6）。IBD- u的IR在2002-2014年为5.2（4.9-5.6）。1990年至2001年间，IBD、UC和CD的年发病率每年增加约7% (P < 0.001)，然后从2002年起每年下降1%-2% （P < 0.001）。IBD、UC和IBD- u的IR在男性中较高，而CD的IR在女性中较高。男性和女性患IBD的终生风险约为2.5%。在瑞典，IBD所有亚型的发病率在1990-2001年间有所上升，但此后有所下降。预计每40个人中就有一人在其一生中被诊断患有IBD。
Background Epidemiological studies have shown inconsistent incidence rates (IRs) for inflammatory bowel disease (IBD). Aim To assess the incidence and temporal trends of IBD in Sweden. Methods Nationwide cohort study based on diagnostic codes for IBD and biopsy reports registered through the ESPRESSO cohort in 1990-2014. Age-specific and age-standardised IRs and cumulative incidence were calculated. Results Overall, we identified 65 908 cases of incident IBD: ulcerative colitis (UC, n = 38 261, 58%), Crohn's disease (CD, n = 18 577, 28%) and IBD-U (n = 9070, 14%). During 1990-2014, the overall IRs per 100 000 person-years were 29.0 (95% CI: 27.3-30.7) for IBD, 16.9 (15.9-17.9) for UC, and 8.1 (7.7-8.6) for CD. For IBD-U, the IR was 5.2 (4.9-5.6) in 2002-2014. The annual incidence of IBD, UC and CD increased by approximately 7% per year between 1990 and 2001 (P < 0.001) and then decreased by 1%-2% per year from 2002 onwards (P < 0.001). IRs for IBD, UC and IBD-U were higher in males while the IR for CD was higher in females. The lifetime risk of IBD was about 2.5% for both sexes. Conclusions In Sweden, the incidence of IBD in all subtypes increased in 1990-2001 but has since declined. One in 40 individuals is expected to be diagnosed with IBD during their lifetime.