Wan Jian, Shen Jun, Wu Xiaoping, Zhong Jie, Chen Yan, Zhu Lanxiang, Miao Yinglei, Hu Naizhong, Chen Jie, Liang Jie, Wu Kaichun
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China.
Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
Therap Adv Gastroenterol. 2023 Dec 14;16:17562848231210367. doi: 10.1177/17562848231210367. eCollection 2023.
The incidence of inflammatory bowel disease (IBD) is rapidly increasing in China, a vast country with significant geographical differences. The socioeconomic status of Eastern China is significantly higher than that of Western China.
This study aimed to describe the geographical heterogeneity in the characteristics and management of patients with IBD in both Eastern and Western China.
This was a multicenter, cross-sectional study.
Patients with IBD with ages ⩾18 years up to 18 January 2023 were included in the analysis from the Chinese database for IBD. Logistic regression was used to identify risk factors associated with surgeries among patients with IBD.
Among 8305 patients with IBD, the ratio of ulcerative colitis (UC) to Crohn's disease (CD) was 4.13 and 0.33 in Western and Eastern China, respectively. The median age at diagnosis of UC and CD was 40.69 and 28.58 years, respectively. There was a male predominance among patients with UC (54.3%) and CD (68.0%). The two regions exhibited a similar distribution of disease locations in UC. However, Western China had a higher proportion of L2 involvement (30.0% 19.1%) and more advanced disease behavior (B2 and B3) (48.8% 39.8%) than Eastern China. Patients with IBD in Western China received more 5-aminosalicylic acid and corticosteroids and fewer immunomodulators and biologicals. In terms of surgical risk, Eastern China [ Western China, odds ratios (OR): 5.36, 95% confidence intervals (CI): 2.96-9.68] was associated with a higher risk of surgery in UC, while Western China ( Eastern China, OR: 3.39, 95% CI: 2.37-4.86) was associated with a higher risk of surgery in CD.
Geographical heterogeneity exists in the disease characteristics and management of IBD in Eastern and Western China. These findings have the potential to guide the formulation of location-specific strategies aimed at enhancing the long-term outcomes of patients with IBD.
在中国这个地域差异显著的大国，炎症性肠病（IBD）的发病率正在迅速上升。中国东部的社会经济地位明显高于西部。
本研究旨在描述中国东部和西部IBD患者特征及治疗方面的地理异质性。
这是一项多中心横断面研究。
从中国IBD数据库中纳入截至2023年1月18日年龄≥18岁的IBD患者进行分析。采用逻辑回归确定IBD患者手术相关的危险因素。
在8305例IBD患者中，溃疡性结肠炎（UC）与克罗恩病（CD）的比例在西部和东部中国分别为4.13和0.33。UC和CD的诊断中位年龄分别为40.69岁和28.58岁。UC患者（54.3%）和CD患者（68.0%）中男性占主导。两个地区UC的病变部位分布相似。然而，中国西部L2受累比例（30.0%对19.1%）更高，疾病行为更严重（B2和B3）（48.8%对39.8%）。中国西部的IBD患者接受更多的5-氨基水杨酸和皮质类固醇，而免疫调节剂和生物制剂较少。在手术风险方面，中国东部（对比中国西部，比值比（OR）：5.36，95%置信区间（CI）：2.96 - 9.68）与UC手术风险较高相关，而中国西部（对比中国东部，OR：3.39，95%CI：2.37 - 4.86）与CD手术风险较高相关。
中国东部和西部IBD的疾病特征及治疗存在地理异质性。这些发现有可能指导制定针对特定地区的策略，以改善IBD患者的长期预后。
