Population Density and Risk of Inflammatory Bowel Disease: A Prospective Population-Based Study in 13 Countries or Regions in Asia-Pacific
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. Newly diagno...
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| Published in | The American journal of gastroenterology Vol. 114; no. 1; pp. 107 - 115 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
01.01.2019
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| Subjects | |
| Online Access | Get full text |
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| Abstract | 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.
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.
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.
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. |
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| AbstractList | 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.
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.
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.
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. 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.INTRODUCTIONLiving 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.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.METHODSNewly 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.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.RESULTSWe 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.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.CONCLUSIONSRegions 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. |
| Author | Adigopula, Bhargavi Simadibrata, Marcellus Hilmi, Ida Aniwan, Satimai Sheng, Hong Yu, Hon Ho Underwood, Fox E. Ching, Jessica Y. L. Cao, Qian Kaplan, Gilaad G. Wei, Shu-Chen Ling, Khoon-Lin Miao, Yinglei Miao, Jiarong Chong, Vui Heng Lin, Hung-Hsin Wu, Justin C. Y. Chen, Minhu Niriella, Madunil Kamm, Michael A. Abdullah, Murdani Ng, Ka Kei Gunawan, Jeffri Ong, David Sung, Joseph J. Y. Ong-Go, Arlinking Niewiadomski, Olga Wu, Kaichun Wang, Yufang Zeng, Zhirong Yang, Hong Ouyang, Qin Ooi, Choon Jin Limsrivilai, Julajak Chan, Francis K. L. Lee Goh, Khean Ng, Siew C. Banerjee, Rupa Bell, Sally Lin, Wei-Chen Hu, Pinjin Janaka de Silva, H. Tang, Whitney Pisespongsa, Pises Tanyingoh, Divine Li, Jin |
| Author_xml | – sequence: 1 givenname: Siew C. surname: Ng fullname: Ng, Siew C. organization: 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 – sequence: 2 givenname: Gilaad G. surname: Kaplan fullname: Kaplan, Gilaad G. organization: Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada – sequence: 3 givenname: Whitney surname: Tang fullname: Tang, Whitney organization: Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China – sequence: 4 givenname: Rupa surname: Banerjee fullname: Banerjee, Rupa organization: Asian Institute of Gastroenterology, Hyderabad, India – sequence: 5 givenname: Bhargavi surname: Adigopula fullname: Adigopula, Bhargavi organization: Asian Institute of Gastroenterology, Hyderabad, India – sequence: 6 givenname: Fox E. surname: Underwood fullname: Underwood, Fox E. organization: Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada – sequence: 7 givenname: Divine surname: Tanyingoh fullname: Tanyingoh, Divine organization: Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada – sequence: 8 givenname: Shu-Chen surname: Wei fullname: Wei, Shu-Chen organization: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan – sequence: 9 givenname: Wei-Chen surname: Lin fullname: Lin, Wei-Chen organization: Mackay Memorial Hospital, Taipei, Taiwan – sequence: 10 givenname: Hung-Hsin surname: Lin fullname: Lin, Hung-Hsin organization: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan – sequence: 11 givenname: Jin surname: Li fullname: Li, Jin organization: Zhongnan Hospital, Wuhan University School of Medicine, Wuhan, China – sequence: 12 givenname: Sally surname: Bell fullname: Bell, Sally organization: St Vincent's Hospital and University of Melbourne, Melbourne, VIC, Australia – sequence: 13 givenname: Olga surname: Niewiadomski fullname: Niewiadomski, Olga organization: St Vincent's Hospital and University of Melbourne, Melbourne, VIC, Australia – sequence: 14 givenname: Michael A. surname: Kamm fullname: Kamm, Michael A. organization: St Vincent's Hospital and University of Melbourne, Melbourne, VIC, Australia – sequence: 15 givenname: Zhirong surname: Zeng fullname: Zeng, Zhirong organization: The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China – sequence: 16 givenname: Minhu surname: Chen fullname: Chen, Minhu organization: The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China – sequence: 17 givenname: Pinjin surname: Hu fullname: Hu, Pinjin organization: The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China – sequence: 18 givenname: David surname: Ong fullname: Ong, David organization: National University Hospital of Singapore, Singapore, Singapore – sequence: 19 givenname: Choon Jin surname: Ooi fullname: Ooi, Choon Jin organization: National University Hospital of Singapore, Singapore, Singapore – sequence: 20 givenname: Khoon-Lin surname: Ling fullname: Ling, Khoon-Lin organization: Singapore General Hospital, Singapore, Singapore – sequence: 21 givenname: Yinglei surname: Miao fullname: Miao, Yinglei organization: The First Affiliated Hospital of Kunming Medical University, Yunnan, China – sequence: 22 givenname: Jiarong surname: Miao fullname: Miao, Jiarong organization: The First Affiliated Hospital of Kunming Medical University, Yunnan, China – sequence: 23 givenname: H. surname: Janaka de Silva fullname: Janaka de Silva, H. organization: Faculty of Medicine, University of Kelaniya, Regama, Sri Lanka – sequence: 24 givenname: Madunil surname: Niriella fullname: Niriella, Madunil organization: Faculty of Medicine, University of Kelaniya, Regama, Sri Lanka – sequence: 25 givenname: Satimai surname: Aniwan fullname: Aniwan, Satimai organization: King Chulalongkorn Memorial Hospital, Bangkok, Thailand – sequence: 26 givenname: Julajak surname: Limsrivilai fullname: Limsrivilai, Julajak organization: Siriraj Hospitial, Bangkok, Thailand – sequence: 27 givenname: Pises surname: Pisespongsa fullname: Pisespongsa, Pises organization: Maharaj Nakorn Chiangmai Hospital, Chiangmai, Thailand – sequence: 28 givenname: Kaichun surname: Wu fullname: Wu, Kaichun organization: Xijing Hospital, Fourth Military Medical University, Xian, China – sequence: 29 givenname: Hong surname: Yang fullname: Yang, Hong organization: Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China – sequence: 30 givenname: Ka Kei surname: Ng fullname: Ng, Ka Kei organization: Hospital Conde S Januário, Macau, China – sequence: 31 givenname: Hon Ho surname: Yu fullname: Yu, Hon Ho organization: Kiangwu Hospital, Macau, China – sequence: 32 givenname: Yufang surname: Wang fullname: Wang, Yufang organization: West China Hospital, Sichuan University, Chengdu, China – sequence: 33 givenname: Qin surname: Ouyang fullname: Ouyang, Qin organization: West China Hospital, Sichuan University, Chengdu, China – sequence: 34 givenname: Murdani surname: Abdullah fullname: Abdullah, Murdani organization: Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia – sequence: 35 givenname: Marcellus surname: Simadibrata fullname: Simadibrata, Marcellus organization: Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia – sequence: 36 givenname: Jeffri surname: Gunawan fullname: Gunawan, Jeffri organization: Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia – sequence: 37 givenname: Ida surname: Hilmi fullname: Hilmi, Ida organization: University of Malaya Medical Centre, Kuala Lumpur, Malaysia – sequence: 38 givenname: Khean surname: Lee Goh fullname: Lee Goh, Khean organization: University of Malaya Medical Centre, Kuala Lumpur, Malaysia – sequence: 39 givenname: Qian surname: Cao fullname: Cao, Qian organization: Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China – sequence: 40 givenname: Hong surname: Sheng fullname: Sheng, Hong organization: Xiangshan People’s Hospital, Xiangshan, China – sequence: 41 givenname: Arlinking surname: Ong-Go fullname: Ong-Go, Arlinking organization: Metropolitan Medical Center, Manila, Philippines – sequence: 42 givenname: Vui Heng surname: Chong fullname: Chong, Vui Heng organization: Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam – sequence: 43 givenname: Jessica Y. L. surname: Ching fullname: Ching, Jessica Y. L. organization: Department of Medicine and Therapeutics, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China – sequence: 44 givenname: Justin C. Y. surname: Wu fullname: Wu, Justin C. Y. organization: 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 – sequence: 45 givenname: Francis K. L. surname: Chan fullname: Chan, Francis K. L. organization: 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 – sequence: 46 givenname: Joseph J. Y. surname: Sung fullname: Sung, Joseph J. Y. organization: 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 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30177785$$D View this record in MEDLINE/PubMed |
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| Title | Population Density and Risk of Inflammatory Bowel Disease: A Prospective Population-Based Study in 13 Countries or Regions in Asia-Pacific |
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