Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries

Shailja C. Shah; Hamed Khalili; Corinne Gower-Rousseau; Ola Olen; Eric I. Benchimol; Elsebeth Lynge; Kári R. Nielsen; Paul Brassard; Maria Vutcovici; Alain Bitton; Charles N. Bernstein; Desmond Leddin; Hala Tamim; Tryggvi Stefansson; Edward V. Loftus; Bjørn Moum; Whitney Tang; Siew C. Ng; Richard Gearry; Brankica Sincic; Sally Bell; Bruce E. Sands; Peter L. Lakatos; Zsuzsanna Végh; Claudia Ott; Gilaad G. Kaplan; Johan Burisch; Jean Frederic Colombel

doi:10.1053/j.gastro.2018.06.043

Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries

Shailja C. Shah^*, Hamed Khalili, Corinne Gower-Rousseau, Ola Olen, Eric I. Benchimol, Elsebeth Lynge, Kári R. Nielsen, Paul Brassard, Maria Vutcovici, Alain Bitton, Charles N. Bernstein, Desmond Leddin, Hala Tamim, Tryggvi Stefansson, Edward V. Loftus, Bjørn Moum, Whitney Tang, Siew C. Ng, Richard Gearry, Brankica SincicSally Bell, Bruce E. Sands, Peter L. Lakatos, Zsuzsanna Végh, Claudia Ott, Gilaad G. Kaplan, Johan Burisch, Jean Frederic Colombel

^*Corresponding author for this work

Section of Environmental Health

54 Citations (Scopus)

Abstract

Background & Aims: Although the incidence of inflammatory bowel diseases (IBDs) varies with age, few studies have examined variations between the sexes. We therefore used population data from established cohorts to analyze sex differences in IBD incidence according to age at diagnosis. Methods: We identified population-based cohorts of patients with IBD for which incidence and age data were available (17 distinct cohorts from 16 regions of Europe, North America, Australia, and New Zealand). We collected data through December 2016 on 95,605 incident cases of Crohn's disease (CD) (42,831 male and 52,774 female) and 112,004 incident cases of ulcerative colitis (UC) (61,672 male and 50,332 female). We pooled incidence rate ratios of CD and UC for the combined cohort and compared differences according to sex using random effects meta-analysis. Results: Female patients had a lower risk of CD during childhood, until the age range of 10–14 years (incidence rate ratio, 0.70; 95% CI, 0.53–0.93), but they had a higher risk of CD thereafter, which was statistically significant for the age groups of 25–29 years and older than 35 years. The incidence of UC did not differ significantly for female vs male patients (except for the age group of 5–9 years) until age 45 years; thereafter, men had a significantly higher incidence of ulcerative colitis than women. Conclusions: In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.

Original language	English
Journal	Gastroenterology
Volume	155
Issue number	4
Pages (from-to)	1079-1089.e3
ISSN	0016-5085
DOIs	https://doi.org/10.1053/j.gastro.2018.06.043
Publication status	Published - 1 Oct 2018

Keywords

Epidemiology
Estrogen
Menopause
Puberty

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Shah, S. C., Khalili, H., Gower-Rousseau, C., Olen, O., Benchimol, E. I., Lynge, E., Nielsen, K. R., Brassard, P., Vutcovici, M., Bitton, A., Bernstein, C. N., Leddin, D., Tamim, H., Stefansson, T., Loftus, E. V., Moum, B., Tang, W., Ng, S. C., Gearry, R., ... Colombel, J. F. (2018). Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries. Gastroenterology, 155(4), 1079-1089.e3. https://doi.org/10.1053/j.gastro.2018.06.043

Shah, SC, Khalili, H, Gower-Rousseau, C, Olen, O, Benchimol, EI, Lynge, E, Nielsen, KR, Brassard, P, Vutcovici, M, Bitton, A, Bernstein, CN, Leddin, D, Tamim, H, Stefansson, T, Loftus, EV, Moum, B, Tang, W, Ng, SC, Gearry, R, Sincic, B, Bell, S, Sands, BE, Lakatos, PL, Végh, Z, Ott, C, Kaplan, GG, Burisch, J & Colombel, JF 2018, 'Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries', Gastroenterology, vol. 155, no. 4, pp. 1079-1089.e3. https://doi.org/10.1053/j.gastro.2018.06.043

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title = "Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries",

abstract = "Background & Aims: Although the incidence of inflammatory bowel diseases (IBDs) varies with age, few studies have examined variations between the sexes. We therefore used population data from established cohorts to analyze sex differences in IBD incidence according to age at diagnosis. Methods: We identified population-based cohorts of patients with IBD for which incidence and age data were available (17 distinct cohorts from 16 regions of Europe, North America, Australia, and New Zealand). We collected data through December 2016 on 95,605 incident cases of Crohn's disease (CD) (42,831 male and 52,774 female) and 112,004 incident cases of ulcerative colitis (UC) (61,672 male and 50,332 female). We pooled incidence rate ratios of CD and UC for the combined cohort and compared differences according to sex using random effects meta-analysis. Results: Female patients had a lower risk of CD during childhood, until the age range of 10–14 years (incidence rate ratio, 0.70; 95% CI, 0.53–0.93), but they had a higher risk of CD thereafter, which was statistically significant for the age groups of 25–29 years and older than 35 years. The incidence of UC did not differ significantly for female vs male patients (except for the age group of 5–9 years) until age 45 years; thereafter, men had a significantly higher incidence of ulcerative colitis than women. Conclusions: In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.",

keywords = "Epidemiology, Estrogen, Menopause, Puberty",

author = "Shah, {Shailja C.} and Hamed Khalili and Corinne Gower-Rousseau and Ola Olen and Benchimol, {Eric I.} and Elsebeth Lynge and Nielsen, {K{\'a}ri R.} and Paul Brassard and Maria Vutcovici and Alain Bitton and Bernstein, {Charles N.} and Desmond Leddin and Hala Tamim and Tryggvi Stefansson and Loftus, {Edward V.} and Bj{\o}rn Moum and Whitney Tang and Ng, {Siew C.} and Richard Gearry and Brankica Sincic and Sally Bell and Sands, {Bruce E.} and Lakatos, {Peter L.} and Zsuzsanna V{\'e}gh and Claudia Ott and Kaplan, {Gilaad G.} and Johan Burisch and Colombel, {Jean Frederic}",

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doi = "10.1053/j.gastro.2018.06.043",

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T1 - Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries

AU - Shah, Shailja C.

AU - Khalili, Hamed

AU - Gower-Rousseau, Corinne

AU - Olen, Ola

AU - Benchimol, Eric I.

AU - Lynge, Elsebeth

AU - Nielsen, Kári R.

AU - Brassard, Paul

AU - Vutcovici, Maria

AU - Bitton, Alain

AU - Bernstein, Charles N.

AU - Leddin, Desmond

AU - Tamim, Hala

AU - Stefansson, Tryggvi

AU - Loftus, Edward V.

AU - Moum, Bjørn

AU - Tang, Whitney

AU - Ng, Siew C.

AU - Gearry, Richard

AU - Sincic, Brankica

AU - Bell, Sally

AU - Sands, Bruce E.

AU - Lakatos, Peter L.

AU - Végh, Zsuzsanna

AU - Ott, Claudia

AU - Kaplan, Gilaad G.

AU - Burisch, Johan

AU - Colombel, Jean Frederic

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background & Aims: Although the incidence of inflammatory bowel diseases (IBDs) varies with age, few studies have examined variations between the sexes. We therefore used population data from established cohorts to analyze sex differences in IBD incidence according to age at diagnosis. Methods: We identified population-based cohorts of patients with IBD for which incidence and age data were available (17 distinct cohorts from 16 regions of Europe, North America, Australia, and New Zealand). We collected data through December 2016 on 95,605 incident cases of Crohn's disease (CD) (42,831 male and 52,774 female) and 112,004 incident cases of ulcerative colitis (UC) (61,672 male and 50,332 female). We pooled incidence rate ratios of CD and UC for the combined cohort and compared differences according to sex using random effects meta-analysis. Results: Female patients had a lower risk of CD during childhood, until the age range of 10–14 years (incidence rate ratio, 0.70; 95% CI, 0.53–0.93), but they had a higher risk of CD thereafter, which was statistically significant for the age groups of 25–29 years and older than 35 years. The incidence of UC did not differ significantly for female vs male patients (except for the age group of 5–9 years) until age 45 years; thereafter, men had a significantly higher incidence of ulcerative colitis than women. Conclusions: In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.

AB - Background & Aims: Although the incidence of inflammatory bowel diseases (IBDs) varies with age, few studies have examined variations between the sexes. We therefore used population data from established cohorts to analyze sex differences in IBD incidence according to age at diagnosis. Methods: We identified population-based cohorts of patients with IBD for which incidence and age data were available (17 distinct cohorts from 16 regions of Europe, North America, Australia, and New Zealand). We collected data through December 2016 on 95,605 incident cases of Crohn's disease (CD) (42,831 male and 52,774 female) and 112,004 incident cases of ulcerative colitis (UC) (61,672 male and 50,332 female). We pooled incidence rate ratios of CD and UC for the combined cohort and compared differences according to sex using random effects meta-analysis. Results: Female patients had a lower risk of CD during childhood, until the age range of 10–14 years (incidence rate ratio, 0.70; 95% CI, 0.53–0.93), but they had a higher risk of CD thereafter, which was statistically significant for the age groups of 25–29 years and older than 35 years. The incidence of UC did not differ significantly for female vs male patients (except for the age group of 5–9 years) until age 45 years; thereafter, men had a significantly higher incidence of ulcerative colitis than women. Conclusions: In a pooled analysis of population-based studies, we found age at IBD onset to vary with sex. Further studies are needed to investigate mechanisms of sex differences in IBD incidence.

KW - Epidemiology

KW - Estrogen

KW - Menopause

KW - Puberty

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U2 - 10.1053/j.gastro.2018.06.043

DO - 10.1053/j.gastro.2018.06.043

M3 - Journal article

C2 - 29958857

AN - SCOPUS:85052940194

SN - 0016-5085

VL - 155

SP - 1079-1089.e3

JO - Gastroenterology

JF - Gastroenterology

IS - 4

ER -

Sex-Based Differences in Incidence of Inflammatory Bowel Diseases—Pooled Analysis of Population-Based Studies From Western Countries

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