East–West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort

作者：Johan M. Burisch, N Pedersen, Silvja Cukovic-Cavka, Marko Brinar, Ioannis P Kaimakliotis, Dana Ďuricová, Olga Shonová, Ida Vind, Søren Avnstrøm, Niels Thorsgaard, Vibeke Charlotte Andersen, Simon Krabbe, Jens Frederik Dahlerup, Riina Salupere, Kári Rubek Nielsen, Jóngerð Olsen, P. Manninen, Pekka Collin, E.V. Tsianos, Konstantinnos H. Katsanos, K. Ladefoged, Peter Laszlo Lakatos, Einar Stefan Bjornsson, Gunnar Bjarni Ragnarsson, Yvonne Bailey, Selwyn H. Odes, Doron Schwartz, Matteo Martinato, Guido Lupinacci, Mónica Milla, Angelo De Padova, Renata D'Incà, Marina Beltrami, Limas Kupčinskas, Gediminas Kiudelis, Svetlana Turcan, O. Tighineanu, Ion Mihu, Fernando Magro, Louisa Barros, Adrian Goldis, Daniela Cornelia Lazăr, Elena A. Belousova, Юлия Александровна Никулина, Vicent Hernández, David Martı́nez-Ares, Sven H. Almer, Y. Zhulina, Jonas Halfvarson, Naila Arebi, Shaji Sebastian, Peter Laszlo Lakatos, Ebbe Langholz, Pia S. Munkholm, for the EpiCom-group · 发表于：Gut · 年份：2013 · DOI：10.1136/gutjnl-2013-304636 · 被引用次数：431 · 研究领域：Inflammatory Bowel Disease、Microscopic Colitis、Clostridium difficile and Clostridium perfringens research

OBJECTIVE: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East-West gradient in the incidence of IBD in Europe exists. DESIGN: A prospective, uniformly diagnosed, population based inception cohort of IBD patients in 31 centres from 14 Western and eight Eastern European countries covering a total background population of approximately 10.1 million people was created. One-third of the centres had previous experience with inception cohorts. Patients were entered into a low cost, web based epidemiological database, making participation possible regardless of socioeconomic status and prior experience. RESULTS: 1515 patients aged 15 years or older were included, of whom 535 (35%) were diagnosed with Crohn's disease (CD), 813 (54%) with ulcerative colitis (UC) and 167 (11%) with IBD unclassified (IBDU). The overall incidence rate ratios in all Western European centres were 1.9 (95% CI 1.5 to 2.4) for CD and 2.1 (95% CI 1.8 to 2.6) for UC compared with Eastern European centres. The median crude annual incidence rates per 100,000 in 2010 for CD were 6.5 (range 0-10.7) in Western European centres and 3.1 (range 0.4-11.5) in Eastern European centres, for UC 10.8 (range 2.9-31.5) and 4.1 (range 2.4-10.3), respectively, and for IBDU 1.9 (range 0-39.4) and 0 (range 0-1.2), respectively. In Western Europe, 92% of CD, 78% of UC and 74% of IBDU patients had a c...