Lee Kang-Moon, Lee Ji Min
Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Intern Med. 2014 Sep;29(5):558-70. doi: 10.3904/kjim.2014.29.5.558. Epub 2014 Aug 28.
The epidemiology, genetics, and clinical manifestations of Crohn's disease (CD) vary considerably among geographic areas and ethnic groups. Thus, identifying the characteristics of Korean CD is important for establishing management strategies appropriate for Korean patients. Since the mid-2000s, many studies have investigated the characteristic features of Korean CD. The incidence and prevalence rates of CD have been increasing rapidly in Korea, especially among the younger population. Unlike Western data, Korean CD shows a male predominance and a lower proportion of isolated colonic disease. Perianal lesions are more prevalent than in Western countries. Genome-wide association studies have confirmed that genetic variants in TNFSF15, IL-23R, and IRGM, but not ATG16L1, are associated with CD susceptibility in the Korean population. Studies of the associations between genetic mutations and the clinical course of CD are underway. Although it has been generally accepted that the clinical course of Korean CD is milder than that in Western countries, recent studies have shown a comparable rate of intestinal resection in Korean and Western CD patients. An ongoing nationwide, hospital-based cohort study is anticipated to provide valuable information on the natural history and prognosis of Korean CD in the near future.
克罗恩病(CD)的流行病学、遗传学及临床表现因地理区域和种族群体的不同而有很大差异。因此,明确韩国CD的特征对于制定适合韩国患者的管理策略至关重要。自21世纪中叶以来,许多研究对韩国CD的特征进行了调查。在韩国,CD的发病率和患病率一直在迅速上升,尤其是在年轻人群体中。与西方数据不同,韩国CD表现为男性居多,孤立性结肠疾病的比例较低。肛周病变比西方国家更为普遍。全基因组关联研究证实,TNFSF15、IL-23R和IRGM基因的变异与韩国人群的CD易感性相关,而ATG16L1基因则不然。关于基因突变与CD临床病程之间关联的研究正在进行中。尽管人们普遍认为韩国CD的临床病程比西方国家更为温和,但最近的研究表明,韩国和西方CD患者的肠道切除率相当。一项正在进行的全国性、基于医院的队列研究预计将在不久的将来提供有关韩国CD自然史和预后的有价值信息。