Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
Gut Liver. 2022 Sep 15;16(5):676-685. doi: 10.5009/gnl210385. Epub 2022 Feb 11.
The burden of inflammatory bowel disease (IBD) in Asia has been increasing over the past decades. Although patients with IBD show heterogenous phenotypes depending on the individual characteristics, no significant differences have been established in the IBD phenotypes of Western and Asian populations. However, despite the much lower incidence of IBD in Asia than in Western countries, the incidence has been rapidly increasing in Asia while remaining stable in Western countries. The incidence of ulcerative colitis (UC) showed an earlier and a more marked increase than the incidence of Crohn disease (CD), but the UC-to-CD ratio has recently decreased because of a relative increase in the incidence of CD in Asia. While CD shows a significant male predominance, UC only shows a slight male predominance. A recent study reported that the incidence of IBD in Asia showed a bimodal age distribution with increasing IBD prevalence, similar to the findings of Western studies. CD in Asian patients, especially those in East Asia, is characterized by ileocolonic involvement and perianal fistula. The frequency of extraintestinal manifestations, including primary sclerosing cholangitis, appears to be lower in Asia, but this finding should be interpreted with caution due to the transient and nonspecific nature of these manifestations. Although familial aggregation is lower in East Asia, it may also be explained by the low prevalence of IBD in Asia. Thus, more studies should focus on the differences in phenotypes in Asian IBD patients versus Western patients.
过去几十年来，亚洲炎症性肠病（IBD）的负担一直在增加。尽管 IBD 患者表现出依赖于个体特征的异质性表型，但西方和亚洲人群的 IBD 表型之间没有建立显著差异。然而，尽管亚洲的 IBD 发病率远低于西方国家，但亚洲的发病率一直在迅速增加，而西方国家的发病率则保持稳定。溃疡性结肠炎（UC）的发病率比克罗恩病（CD）更早且更显著增加，但由于亚洲 CD 发病率的相对增加，UC 与 CD 的比例最近有所下降。CD 表现出明显的男性优势，而 UC 仅表现出轻微的男性优势。最近的一项研究报告称，亚洲的 IBD 发病率呈现出双峰年龄分布，随着 IBD 患病率的增加，与西方研究的结果相似。亚洲患者，特别是东亚患者的 CD 以回肠结肠受累和肛周瘘管为特征。包括原发性硬化性胆管炎在内的肠外表现的频率似乎较低，但由于这些表现具有短暂性和非特异性，因此这一发现应谨慎解释。尽管东亚的家族聚集程度较低，但这也可能归因于亚洲 IBD 的低患病率。因此，更多的研究应集中于亚洲 IBD 患者与西方患者的表型差异。
