Geographical variations of inflammatory bowel disease in France: A study based on national health insurance data

Nerich, Virginie; Monnet, Élisabeth; Etienne, Arnaud; Louafi, Samy; Ramée, Cécile; Rican, Stéphane; Weill, Alain; Vallier, N; Vanbockstael, Vincent; Auleley, Guy-Robert; Allemand, H.; Carbonnel, Franck

doi:10.1097/01.mib.0000206540.38834.8c

Cited by 149 publications

(91 citation statements)

References 34 publications

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“…In contrast to the higher incidence of CU in the "northern" cohort of Copenhagen compared to the data of the "southern" cohorts from Oberpfalz and Croatia, recent findings from France show a north-south gradient for CD with lower incidences in southern parts of France [30]. As possible reasons for the higher incidence of CD in the northern areas, the authors discuss a more "prudent diet" with fruits, vegetable, fish and olive oil preferred in southern France, compared to diet-habits with more consumption of sausage, butter and beer in the north, which might have influences on the different incidence.…”

Section: Discussionmentioning

confidence: 49%

The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study

Ott

Obermeier

Thieler

et al. 2008

European Journal of Gastroenterology & Hepatology

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The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study Abstract OBJECTIVE: Although important advances in understanding the aetiology and pathogenesis of inflammatory bowel disease (IBD) have been made, many questions remain unanswered. As the most recent data available on the incidence of IBD in Germany were collected about 15 years ago, we set up a new population-based cohort to determine current incidence data for a defined region in Germany and to establish a basic cohort for prospective follow-up. METHODS: All patients living in the region of Oberpfalz newly diagnosed with IBD between 1 January 2004 and 31 December 2006 were included in this study by setting up a network of reporting clinicians and general practitioners in hospitals as well as in private practices. Demographic and clinical characteristics such as age at first diagnosis, localization of the disease, extraintestinal manifestations or family history on IBD were documented. Age-adjusted incidence rates are presented with 95% Poisson confidence intervals (CIs), based on the European standard population. RESULTS: In total, 286 newly diagnosed patients with IBD were reported in this region, 168 patients suffering from Crohn's disease (CD), 105 patients with ulcerative colitis. Age-standardized incidence rates were 11.0/10(5) (95% CI: 9.1-11.6) for IBD, 6.6/10(5) (95% CI: 5.6-7.7) for CD and 3.9/10(5) (95% CI: 3.2-4.7) for ulcerative colitis. Peak incidences were found in the age interval of 16-24 years for both diseases, predominantly for CD. Age at first diagnosis was lower, extraintestinal manifestations and a positive family history on IBD were more common in patients with CD. CONCLUSION: The incidence rate in IBD seems to be stable in Germany as compared with previously reported data, as is the remarkable predominance of CD. Prospective follow-up studies will be based on this incidence cohort.Incidence of IBD in the region of Oberpfalz ResultsIn total, 286 newly diagnosed patients with IBD were reported from this region, 168 patients suffering from Crohn´s disease (CD), 105 patients with ulcerative colitis (UC). Agestandardized incidence rates were 11.0/10 5 (95% CI 9.1-11.6) for IBD, 6.6/10 5 (95% CI 5.6-7.7) for CD and 3.9/10 5 (95% CI 3.2-4.7 ) for UC respectively. Peak-incidences were found in the age interval 16-24 years for both diseases with a lower extent in UC. Age at first diagnosis was lower, and extraintestinal manifestations and family history on IBD were more common in patients with CD. ConclusionThe incidence rate in IBD seems to be stable in Germany as compared to previously reported data, as is the remarkable predominance of CD.

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Section: Discussionmentioning

confidence: 49%

The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study

Ott

Obermeier

Thieler

et al. 2008

European Journal of Gastroenterology & Hepatology

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“…Higher overall incidence was found in northern centres than in those from the south. This geographical phenomenon was confirmed for CD in France for the period 2000-2002 (13). Incidence rates for both diseases are higher in urban areas than in rural areas.…”

Section: Oral Manifestations In Patients With Ibdsupporting

confidence: 49%

Oral Cavity and Systemic Diseases—Inflammatory Bowel Diseases

Panov

Krasteva

Kisselova

2011

Biotechnology & Biotechnological Equipment

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“…In the Northern Hemisphere, the symptomatic onset of UC peaks in the winter months, the season with the least availability of UVB radiation (2,3). In addition, Northern Hemisphere populations that reside at higher latitudes where daily sunlight exposure is lower have a higher prevalence of IBD, particularly Crohn disease (4,5). Previous analyses have also reported a high prevalence of vitamin D deficiency in patients with both Crohn disease and UC (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 79%

Serum 25-hydroxyvitamin D concentration is inversely associated with mucosal inflammation in patients with ulcerative colitis,

Meckel¹,

Li²,

Lim³

et al. 2016

The American Journal of Clinical Nutrition

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Background: Vitamin D exerts anti-inflammatory actions both in vitro and in murine models of colitis. In previous studies, we demonstrated that vitamin D protects against the development of colitis by maintaining the integrity of the intestinal mucosal barrier. Objective: We sought to evaluate whether deficient serum 25 hydroxyvitamin D [25(OH)D] concentrations are associated with increased mucosal inflammation, a loss of epithelial junctional proteins, and an increase in mucosal inflammatory cytokines in patients with ulcerative colitis (UC). Design: We prospectively enrolled 230 subjects with UC. Serum 25(OH)D concentrations were compared with the Mayo endoscopic score, the total Mayo score, and histologic activity. Colonic mucosal expression concentrations of vitamin D receptor (VDR), E-cadherin, zonula occluden 1 (ZO-1), occludin, claudin-2, tumor necrosis factor a (TNF-a), and interleukin 8 (IL-8) were compared between dichotomous groups with low or high serum 25(OH)D concentrations. Results: The mean serum 25(OH)D concentration was 21.8 ng/mL. Subjects stratified by concentrations included 12.6% $30 ng/mL, 45.6% $20 to ,30 ng/mL, 37.4% $10 to ,20 ng/mL, and 4.4% ,10 ng/mL. There was an inverse association between serum 25(OH)D concentrations and mucosal inflammation as assessed by the Mayo endoscopy score (P = 0.01), disease activity as indicated by the total Mayo score (P = 0.001), and histologic activity (P = 0.02). A serum 25(OH)D concentration ,20 ng/mL was associated with decreased mucosal transcript and protein expression concentrations of VDR, E-cadherin, and occludin as well as decreased protein expression of ZO-1, whereas TNF-a and IL-8 mucosal transcript expression concentrations were increased. Conclusions: In UC patients, serum 25(OH)D concentration is inversely correlated with mucosal inflammation and disease activity. These results, coupled with the findings that serum 25(OH)D concentrations correlate with the mucosal expression of VDR as well as epithelial junction proteins and inversely with proinflammatory cytokines, suggest that vitamin D deficiency may contribute to UC inflammation by disrupting epithelial barrier function.Am J Clin Nutr 2016;104:113-20.

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Geographical variations of inflammatory bowel disease in France: A study based on national health insurance data

Abstract: This study shows a north-south gradient in France for CD but not for UC.

Cited by 149 publications

References 34 publications

The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study

The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study

Oral Cavity and Systemic Diseases—Inflammatory Bowel Diseases

Serum 25-hydroxyvitamin D concentration is inversely associated with mucosal inflammation in patients with ulcerative colitis,

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