Institute of Digestive Disease, Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Institute of Digestive Disease, Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Gastroenterology. 2013 Jul;145(1):158-165.e2. doi: 10.1053/j.gastro.2013.04.007. Epub 2013 Apr 9.
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.
We performed a prospective, population-based study of IBD incidence in predefined 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.
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).
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.
炎症性肠病（IBD）在亚洲变得越来越普遍，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 个国家和澳大利亚的 IBD 发病率和表型。
我们对 IBD 的发病率进行了前瞻性、基于人群的研究，在预先确定的集水区内收集了为期 1 年的数据，从 2011 年 4 月 1 日开始。通过多个重叠的来源确定新病例，并将其输入到基于网络的数据库中。使用标准标准确认病例。搜索本地内窥镜、病理学和药房记录，以确保病例采集完整。
我们确定了 419 例新的 IBD 病例（232 例溃疡性结肠炎[UC]，166 例克罗恩病[CD]，21 例 IBD 不确定）。每 100,000 人年的粗发病率分别为亚洲的 IBD 为 1.37（95%置信区间：1.25-1.51；0.76 为 UC，0.54 为 CD，0.07 为 IBD 不确定）和澳大利亚的 23.67（95%置信区间：18.46-29.85；7.33 为 UC，14.00 为 CD，2.33 为 IBD 不确定）。中国是亚洲 IBD 发病率最高的国家（每 100,000 人 3.44 人）。亚洲 UC 与 CD 的比例为 2.0，澳大利亚为 0.5。从症状出现到诊断的中位时间为 5.5 个月（四分位距，1.4-15 个月）。亚洲复杂 CD（狭窄、穿透或肛周疾病）比澳大利亚更常见（52%比 24%；P =.001），亚洲的 IBD 家族史较少（3%比 17%；P <.001）。
我们进行了一项大规模的基于人群的研究，发现尽管亚洲 IBD 的发病率有所不同，但仍低于西方国家。亚洲的 IBD 可能比西方更严重或更严重。IBD 在亚洲的出现将需要特定的医疗保健资源，为研究发展中国家的病因提供了独特的机会。
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