Siew C Ng1, Gilaad G Kaplan2, Whitney Tang3, Rupa Banerjee4, Bhargavi Adigopula4, Fox E Underwood2, Divine Tanyingoh2, Shu-Chen Wei5, Wei-Chen Lin6, Hung-Hsin Lin7, Jin Li8, Sally Bell9, Olga Niewiadomski9, Michael A Kamm9, Zhirong Zeng10, Minhu Chen10, Pinjin Hu10, David Ong11, Choon Jin Ooi11, Khoon-Lin Ling12, Yinglei Miao13, Jiarong Miao13, H Janaka de Silva14, Madunil Niriella14, Satimai Aniwan15, Julajak Limsrivilai16, Pises Pisespongsa17, Kaichun Wu18, Hong Yang19, Ka Kei Ng20, Hon Ho Yu21, Yufang Wang22, Qin Ouyang22, Murdani Abdullah23, Marcellus Simadibrata23, Jeffri Gunawan23, Ida Hilmi24, Khean Lee Goh24, Qian Cao25, Hong Sheng26, Arlinking Ong-Go27, Vui Heng Chong28, Jessica Y L Ching3, Justin C Y Wu1, Francis K L Chan1, Joseph J Y Sung1. 1. Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory Of Digestive Diseases, LKS Institute of Health Science, Chinese University of Hong Kong, Hong Kong, China. 2. Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada. 3. Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China. 4. Asian Institute of Gastroenterology, Hyderabad, India. 5. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 6. Mackay Memorial Hospital, Taipei, Taiwan. 7. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan. 8. Zhongnan Hospital, Wuhan University School of Medicine, Wuhan, China. 9. St Vincent's Hospital and University of Melbourne, Melbourne, VIC, Australia. 10. The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 11. National University Hospital of Singapore, Singapore, Singapore. 12. Singapore General Hospital, Singapore, Singapore. 13. The First Affiliated Hospital of Kunming Medical University, Yunnan, China. 14. Faculty of Medicine, University of Kelaniya, Regama, Sri Lanka. 15. King Chulalongkorn Memorial Hospital, Bangkok, Thailand. 16. Siriraj Hospitial, Bangkok, Thailand. 17. Maharaj Nakorn Chiangmai Hospital, Chiangmai, Thailand. 18. Xijing Hospital, Fourth Military Medical University, Xian, China. 19. Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China. 20. Hospital Conde S Januário, Macau, China. 21. Kiangwu Hospital, Macau, China. 22. West China Hospital, Sichuan University, Chengdu, China. 23. Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 24. University of Malaya Medical Centre, Kuala Lumpur, Malaysia. 25. Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. 26. Xiangshan People's Hospital, Xiangshan, China. 27. Metropolitan Medical Center, Manila, Philippines. 28. Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam.
Abstract
INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude. RESULTS: We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval. CONCLUSIONS: Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia.
INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude. RESULTS: We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval. CONCLUSIONS: Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia.
Authors: Adam Tepler; Neeraj Narula; Richard M Peek; Anish Patel; Cyrus Edelson; Jean-Frederic Colombel; Shailja C Shah Journal: Aliment Pharmacol Ther Date: 2019-06-05 Impact factor: 8.171
Authors: J Dhaliwal; M W Carroll; J C deBruyn; A Ricciuto; E I Benchimol; S Lawrence; M Sherlock; W El-Matary; H Brill; P Church; E Wine; N Carman; A Muise; H Huynh; D R Mack; T D Walters; A M Griffiths; K Jacobson Journal: J Crohns Colitis Date: 2022-02-23 Impact factor: 10.020
Authors: Philipp Schreiner; Markus F Neurath; Siew C Ng; Emad M El-Omar; Ala I Sharara; Taku Kobayashi; Tadakazu Hisamatsu; Toshifumi Hibi; Gerhard Rogler Journal: Inflamm Intest Dis Date: 2019-07-09
Authors: Maryam Alkhatry; Ahmad Al-Rifai; Vito Annese; Filippos Georgopoulos; Ahmad N Jazzar; Ahmed M Khassouan; Zaher Koutoubi; Rahul Nathwani; Mazen S Taha; Jimmy K Limdi Journal: World J Gastroenterol Date: 2020-11-21 Impact factor: 5.742