Influence of Socioeconomic Development on Incidence and Disease Phenotype in Inflammatory Bowel Disease: A Population-Based Incident Study Across 16 Regions.

IF 16.2 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical Gastroenterology and Hepatology Pub Date : 2026-09-08 DOI:10.1016/j.cgh.2026.08.031

Joyce W Y Mak, Agnes H Y Hom, Alicia K W Chan, Yinglei Miao, Yang Sun, Hang Viet Dao, Jamilya Kaibullayeva, Mukesh Sharma Paudel, Julajak Limsrivilai, Shu Chen Wei, Mansour Altuwaijri, Murdani Abdullah, Jesus K Yamamoto-Furusho, Domingo Balderramo, Raja Affendi Raja Ali, Ida Hilmi, Ka Kei Ng, Paul Kelly, Vui Heng Chong, Beatriz Iade Vergara, Yee Kit Tse, Ivan S F Lau, Julia Gorospe, Lindsay Hracs, Stephanie Coward, Joseph W Windsor, Gilaad G Kaplan, Siew C Ng

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引用次数: 0

Abstract

Background & aims: The global rise in inflammatory bowel disease (IBD) parallels socioeconomic development, but its influence on disease epidemiology and phenotype remains unclear. We aimed to characterize IBD incidence, clinical features, and associations with socioeconomic indices across newly industrialized countries.

Methods: This prospective population-based study spanned 16 regions in Africa, Asia, Latin America, and the Middle East from October 2021 for 1 year. Poisson regression estimated incidence rate ratios (IRRs) for Human Development Index (HDI), Sociodemographic Index, subnational HDI, and urban population percentage. Mixed-effects models examined associations with disease phenotype, activity, and treatment.

Results: Of 606 incident cases (229 Crohn's disease [CD], 348 ulcerative colitis [UC], 29 IBD-unclassified), incidence varied widely. Hong Kong had the highest crude annual incidence (IBD, 7.43; CD, 2.69; UC, 3.44) and Vietnam the lowest (IBD, 0.13; CD, 0.04; UC, 0.08). Urban population (per 10% increase) was associated with a higher incidence of IBD (IRR, 1.68), CD (IRR, 1.73), and UC (IRR, 1.62). The HDI and Sociodemographic Index significantly correlated with CD (IRR, 4.05 and 2.96, respectively), but not subnational HDI. Higher HDI and subnational HDI were associated with increased odds of perianal CD (adjusted odds ratio, 2.61 and 2.40, respectively). Other disease phenotypes, activities, and treatment patterns were not significantly linked to any index.

Conclusions: Higher urbanization and development are associated with higher IBD incidence, particularly CD, but not with disease activity at diagnosis. Notably, perianal CD was more common in regions with higher HDI and subnational HDI, suggesting an association with regional socioeconomic development. These highlight the need for region-specific early diagnosis strategies.

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社会经济发展对炎症性肠病发病率和疾病表型的影响：一项跨16个地区的基于人群的事件研究

全球炎症性肠病（IBD）的增加与社会经济发展同步，但其对疾病流行病学和表型的影响尚不清楚。我们旨在描述新兴工业化国家IBD发病率、临床特征及其与社会经济指数的关系。方法：这项基于人群的前瞻性研究从2021年10月开始，横跨非洲、亚洲、拉丁美洲和中东的16个地区，为期一年。泊松回归估计了人类发展指数（HDI）、社会人口指数（SDI）、次国家HDI和城市人口百分比的发病率比（IRR）。混合效应模型检验了疾病表型、活动性和治疗的相关性。结果：606例病例中（克罗恩病229例，溃疡性结肠炎348例，ibd未分类29例），发病率差异很大。香港原油年发病率最高（IBD 7.43; CD 2.69; UC 3.44），越南最低（0.13;0.04;0.08）。城市人口（每增加10%）与IBD （IRR 1.68）、CD （IRR 1.73）和UC （IRR 1.62）的高发病率相关。HDI和SDI与CD显著相关（IRR分别为4.05和2.96），但次国家级HDI不显著。较高的HDI和次国家HDI与肛周CD的几率增加相关（调整OR为2.61和2.40）。其他疾病的表型、活动性和治疗模式与任何指标均无显著相关性。结论：较高的城市化和发展与较高的IBD发病率相关，尤其是CD，但与诊断时的疾病活动性无关。值得注意的是，肛周CD在HDI和次国家HDI较高的地区更为常见，这表明与地区社会经济发展有关。这些突出表明需要制定针对特定区域的早期诊断战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

16.90

自引率

4.80%

发文量

903

审稿时长

22 days

期刊介绍： Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.