Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
Department of Medicine, Kantonsspital Frauenfeld, Frauenfeld, Switzerland.
Digestion. 2020;101 Suppl 1:98-104. doi: 10.1159/000504701. Epub 2020 Jan 29.
Immune-mediated diseases typically show a female preponderance. Looking at all autoimmune diseases combined, 8 of 10 patients are females. Although not as prominent, gender differences in inflammatory bowel disease (IBD) have been reported for epidemiology, disease presentation, disease course and complications, medical and surgical therapies, adherence, psychosocial functioning, and psychiatric co-disorders. While for some factors evidence is rather good, for others data are conflicting. Gastroenterologists dealing with IBD patients in daily clinical practice should be aware of gender-specific issues for the following reasons: (1) misperception of disease presentation potentially delays IBD diagnosis, which has been shown to have deleterious effects, and (2) awareness of gender-specific symptoms and disease severity allows initiation of early and adequately tailored treatment. This might prevent development of complications. And (3) insights into gender-specific differences in terms of treatment and adherence to treatment can improve disease management and foster a more individualized treatment approach. In this review, we summarize current knowledge about gender-specific differences in IBD and highlight the most clinically relevant aspects.
自身免疫性疾病通常表现出女性倾向。纵观所有自身免疫性疾病，80%的患者为女性。虽然炎症性肠病（IBD）的性别差异不如自身免疫性疾病那么明显，但在流行病学、疾病表现、疾病过程和并发症、医学和手术治疗、依从性、社会心理功能和精神共病方面已有报道。虽然对于某些因素，证据相当充分，但对于其他因素，数据则存在矛盾。由于以下原因，在日常临床实践中处理 IBD 患者的胃肠病学家应该意识到与性别相关的问题：（1）对疾病表现的误解可能会延迟 IBD 的诊断，而这已被证明具有有害影响，（2）了解与性别相关的症状和疾病严重程度可以尽早开始并进行适当的个体化治疗。这可能会预防并发症的发生。（3）了解治疗和治疗依从性方面的性别差异可以改善疾病管理并促进更个体化的治疗方法。在这篇综述中，我们总结了目前关于 IBD 中性别差异的知识，并强调了最具临床相关性的方面。
