Late-Onset Crohn’s Disease Is A Subgroup Distinct in Genetic and Behavioral Risk Factors With UC-Like Characteristics

Li, Dalin; Haritunians, Talin; Landers, Carol J.; Potdar, Alka A.; Yang, Shaohong; Huang, Hailiang; Schumm, L. Philip; Daly, Mark J.; Targan, Stephan R.; McGovern, Dermot P.

doi:10.1093/ibd/izy148

Cited by 14 publications

(8 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We therefore sought to investigate the association between relative adherence to a Mediterranean diet and risk of incident CD and UC in two large prospective cohorts of men and women in Sweden. With detailed and validated data on dietary information on over 80 000 middle-aged men and women, these cohorts offered us a unique opportunity to examine the relationship between diet and later-onset IBD, where relative to younger-onset disease the overall contribution of environment is significantly greater 14 15…”

Section: Introductionmentioning

confidence: 99%

Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies

Khalili¹,

Håkansson

Chan³

et al. 2020

Gut

136

108

View full text Add to dashboard Cite

ObjectiveTo examine the relationship between Mediterranean diet and risk of later-onset Crohn’s disease (CD) or ulcerative colitis (UC).DesignWe conducted a prospective cohort study of 83 147 participants (age range: 45–79 years) enrolled in the Cohort of Swedish Men and Swedish Mammography Cohort. A validated food frequency questionnaire was used to calculate an adherence score to a modified Mediterranean diet (mMED) at baseline in 1997. Incident diagnoses of CD and UC were ascertained from the Swedish Patient Register. We used Cox proportional hazards modelling to calculate HRs and 95% CI.ResultsThrough December of 2017, we confirmed 164 incident cases of CD and 395 incident cases of UC with an average follow-up of 17 years. Higher mMED score was associated with a lower risk of CD (Ptrend=0.03) but not UC (Ptrend=0.61). Compared with participants in the lowest category of mMED score (0–2), there was a statistically significant lower risk of CD (HR=0.42, 95% CI 0.22 to 0.80) but not UC (HR=1.08, 95% CI 0.74 to 1.58). These associations were not modified by age, sex, education level, body mass index or smoking (all Pinteraction >0.30). The prevalence of poor adherence to a Mediterranean diet (mMED score=0–2) was 27% in our cohorts, conferring a population attributable risk of 12% for later-onset CD.ConclusionIn two prospective studies, greater adherence to a Mediterranean diet was associated with a significantly lower risk of later-onset CD.

show abstract

Section: Introductionmentioning

confidence: 99%

Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies

Khalili¹,

Håkansson

Chan³

et al. 2020

Gut

136

108

View full text Add to dashboard Cite

show abstract

“…There is mounting evidence to suggest that some disease labels are in fact umbrella terms, which encompass distinct disease subtypes with different underlying mechanisms and clinical symptom manifestations [1][2][3]. This has encouraged the investigation into heterogeneity within disease populations, which has received considerable interest across diverse domains of medicine [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Challenges of Clustering Multimodal Clinical Data: Review of Applications in Asthma Subtyping

Horne¹,

Tibble²,

Sheikh³

et al. 2020

JMIR Med Inform

View full text Add to dashboard Cite

Background In the current era of personalized medicine, there is increasing interest in understanding the heterogeneity in disease populations. Cluster analysis is a method commonly used to identify subtypes in heterogeneous disease populations. The clinical data used in such applications are typically multimodal, which can make the application of traditional cluster analysis methods challenging. Objective This study aimed to review the research literature on the application of clustering multimodal clinical data to identify asthma subtypes. We assessed common problems and shortcomings in the application of cluster analysis methods in determining asthma subtypes, such that they can be brought to the attention of the research community and avoided in future studies. Methods We searched PubMed and Scopus bibliographic databases with terms related to cluster analysis and asthma to identify studies that applied dissimilarity-based cluster analysis methods. We recorded the analytic methods used in each study at each step of the cluster analysis process. Results Our literature search identified 63 studies that applied cluster analysis to multimodal clinical data to identify asthma subtypes. The features fed into the cluster algorithms were of a mixed type in 47 (75%) studies and continuous in 12 (19%), and the feature type was unclear in the remaining 4 (6%) studies. A total of 23 (37%) studies used hierarchical clustering with Ward linkage, and 22 (35%) studies used k-means clustering. Of these 45 studies, 39 had mixed-type features, but only 5 specified dissimilarity measures that could handle mixed-type features. A further 9 (14%) studies used a preclustering step to create small clusters to feed on a hierarchical method. The original sample sizes in these 9 studies ranged from 84 to 349. The remaining studies used hierarchical clustering with other linkages (n=3), medoid-based methods (n=3), spectral clustering (n=1), and multiple kernel k-means clustering (n=1), and in 1 study, the methods were unclear. Of 63 studies, 54 (86%) explained the methods used to determine the number of clusters, 24 (38%) studies tested the quality of their cluster solution, and 11 (17%) studies tested the stability of their solution. Reporting of the cluster analysis was generally poor in terms of the methods employed and their justification. Conclusions This review highlights common issues in the application of cluster analysis to multimodal clinical data to identify asthma subtypes. Some of these issues were related to the multimodal nature of the data, but many were more general issues in the application of cluster analysis. Although cluster analysis may be a useful tool for investigating disease subtypes, we recommend that future studies carefully consider the implications of clustering multimodal data, the cluster analysis process itself, and the reporting of methods to facilitate replication and interpretation of findings.

show abstract

“…(5) Recent analyses from the IBD Genetic Consortium observed that among late onset CD patients (> 55 years of age), the prevalence of colonic CD was greater than ileal CD. (6) A notable observation is that there is a higher prevalence of smokers with ileal CD as compared with colonic CD (50% vs. 38%, p<0.01). (5, 7) Smoking quantity and behavior has been associated with risk for development of CD, and among those with established CD it is associated with an increased risk for disease-related complications,(7–9) which are seen more often in ileal CD versus colonic CD as discussed below.…”

Section: Epidemiology and Natural Historymentioning

confidence: 95%

Should We Divide Crohn’s Disease Into Ileum-Dominant and Isolated Colonic Diseases?

Dulai

Singh

Casteele

et al. 2019

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

Crohn’s disease (CD) is an inflammatory bowel disease, which can involve any region of the gastrointestinal tract. First described in 1932 as terminal ileitis or regional enteritis, it predominately involves the ileum with or without colonic involvement. Isolated colonic CD was first described in 1960 and since then the phenotypic classification of CD has evolved to stratify patients into isolated ileal, ileocolonic, or isolated colonic involvement. In the current review we evaluate the published literature regarding differences in epidemiology, natural history, pathogenesis, response to therapy, and disease monitoring, when stratified by disease location. Based on the available evidence consideration could be given to a new classification for CD, which splits it into ileum dominant (isolated ileal and ileocolonic) and isolated colonic disease. This may allow for a more optimized approach to clinical care and scientific research for CD.

show abstract

Late-Onset Crohn’s Disease Is A Subgroup Distinct in Genetic and Behavioral Risk Factors With UC-Like Characteristics

Abstract: Late-onset CD is subgroup distinct in genetic and behavioral risk factors with UC-like characteristics. 10.1093/ibd/izy148_video1izy148.video15791413461001.

Cited by 14 publications

References 60 publications

Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies

Adherence to a Mediterranean diet is associated with a lower risk of later-onset Crohn’s disease: results from two large prospective cohort studies

Challenges of Clustering Multimodal Clinical Data: Review of Applications in Asthma Subtyping

Should We Divide Crohn’s Disease Into Ileum-Dominant and Isolated Colonic Diseases?

Contact Info

Product

Resources

About