Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark; The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York.
Center for Molecular Prediction of Inflammatory Bowel Disease (PREDICT), Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark.
Gastroenterology. 2022 Dec;163(6):1547-1554.e5. doi: 10.1053/j.gastro.2022.07.062. Epub 2022 Aug 8.
BACKGROUND & AIMS: Shifts in epidemiological stages of inflammatory bowel disease (IBD) carry implications toward understanding IBD etiology and managing clinical care. We conducted a temporal analysis of the epidemiology of IBD between 1995 and 2016 in the Danish nationwide cohort.
We used the Danish registers to obtain data on demographics and IBD-related outpatient and inpatient contacts between 1995 and 2016. IBD diagnosis was defined as having ≥2 registrations related to Crohn's disease (CD) or ulcerative colitis (UC) within a 2-year period. We estimated overall and annual incidence rates and prevalence of CD and UC standardized with respect to age and sex.
A total of 47,830 individuals met the criteria for IBD diagnosis, of which 33% were diagnosed with CD and 67% with UC. Between 1995 and 2016, the incidence rate (95% confidence interval) per 100,000 person-years rose from 9.1 (8.3-10.0) to 17.8 (16.8-19.0) for CD, and from 21.0 (19.8-22.3) to 28.4 (27.0-29.8) for UC. The highest increase in CD and UC incidence rates occurred in children and young adults, respectively. The prevalence of IBD doubled from 1995 to 2016; the greatest increase (2.5-fold) was in UC prevalence among individuals aged >40 years. During this period, the median age of the IBD population increased by 6 to 7 years.
In Denmark, the incidence and prevalence of IBD have increased during the last 2 decades. The IBD population is shifting toward an older age. These findings have implications towards understanding environmental shifts as well as preparing health care systems for an aging IBD population.
炎症性肠病（IBD）的流行病学阶段变化对了解 IBD 的病因和临床管理具有重要意义。我们对丹麦全国队列中 1995 年至 2016 年间 IBD 的流行病学进行了时间分析。
我们使用丹麦登记处获取了 1995 年至 2016 年间与 IBD 相关的门诊和住院接触的人口统计学数据。IBD 诊断定义为在 2 年内有≥2 次与克罗恩病（CD）或溃疡性结肠炎（UC）相关的记录。我们估计了 CD 和 UC 的总体和年度发病率以及标准化后的患病率，同时考虑了年龄和性别因素。
共有 47830 人符合 IBD 诊断标准，其中 33%被诊断为 CD，67%为 UC。1995 年至 2016 年间，每 100000 人年的发病率（95%置信区间）从 CD 的 9.1（8.3-10.0）上升到 17.8（16.8-19.0），UC 从 21.0（19.8-22.3）上升到 28.4（27.0-29.8）。CD 和 UC 发病率的最高增幅发生在儿童和青年人群中。1995 年至 2016 年间，IBD 的患病率翻了一番；40 岁以上人群中 UC 的患病率增幅最大（增加了 2.5 倍）。在此期间，IBD 人群的中位年龄增加了 6 至 7 岁。
在丹麦，过去 20 年来 IBD 的发病率和患病率有所增加。IBD 人群的年龄结构正在向老龄化转变。这些发现对了解环境变化以及为老龄化的 IBD 人群做好医疗保健系统的准备具有重要意义。
