The Disease Burden and Clinical Characteristics of Inflammatory Bowel Disease in the Chinese Population: A Systematic Review and Meta-Analysis

Abstract

The temporal trend of inflammatory bowel disease (IBD) incidence is reported to be increasing in worldwide regions; however, reports focusing on China are sparse. The aim of this study was to provide an overview of the disease burden and clinical features of IBD in the Chinese population. We searched Medline, EMBASE, and another two Chinese databases. A parallel literature review and data extraction were conducted. Meta-analysis was performed to estimate the summary incidence rate of Crohn’s disease (CD) and ulcerative colitis (UC). The constituent ratios with 95% CI were calculated for clinical phenotypes and classifications. The literature review included 47 publications. The summary incidence rate of IBD was 1.74 (95% CI: 1.08; 2.40) per 100,000 person years, and the corresponding incidence rates of CD and UC were 0.40 (95% CI: 0.23; 0.57) and 1.18 (95% CI: 0.81; 1.56) per 100,000 person years, respectively. The sex distribution analysis indicated a male predominance in both CD (sex ratio: 1.64; 95% CI: 1.47–1.84) and UC (sex ratio: 1.29; 95% CI: 1.21–1.38). The clinical characteristics were summarized using data from 2283 CD cases and 17,958 UC cases; in which the majority of CD patients were diagnosed between 17–40 years of age, with non-stricturing and non-penetrating disease, varied disease locations, and less extra-intestinal manifestation. UC cases were featured with later disease diagnosis, a more severe disease course, more segmental lesions, and less extra-intestinal manifestations. Our study provided an estimated disease burden of IBD and demonstrated distinct clinical features in the Chinese population. Large-scale population-based studies are needed to further evaluate these findings.

Risk Factors for Postoperative Recurrence in Korean Patients with Crohn’s Disease

“…Also, age-specific environmental factors or different sensitivities to certain infectious factors might cause a second small peak onset of CD. 16,17 Previously, the surgical recurrence rate in Western CD patients was 20%-50% compared to 14%-25% in Korean CD patients including present study within 5 years. 5,18 Lower recurrence rate in Korean patients is might be due to the lower smoking rate and the genetic difference making less aggressive natural course compared to Western CD patients.…”

Oral manifestations of gastrointestinal disorders

“…It has been estimated that CD affects approximately 1% of the world’s population ( 21 ), but over the last years, CD has experienced a large increase, affecting 1 in every 85 to 300 people ( 20 ). Celiac disease is more common in European countries as well as developing regions such as South America, South Asia and South Africa.…”

“…Despite being typically developed in childhood, recent studies reported an increase in the involvement of adults. Women are considerably more affected than men, presenting a female-male ratio from 7:1 ( 21 ).…”

Increased risks of dental caries and periodontal disease in Chinese patients with inflammatory bowel disease

“…As the economic status and dietary structures of the general public continue to improve in developing countries, the incidence of IBD in Asia has gradually increased. In China, the incidences of UC and CD are approximately 1.18/100,000 and 0.40/100,000. IBD preferentially manifests in the second and fourth decades of life, and can affect any part of the gastrointestinal tract.…”