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Title: | Population density and risk of inflammatory bowel disease: a prospective population-based study in 13 countries or regions in Asia-Pacific. |
Authors: | Ng, S.C. Kaplan, G.G. Tang, W. Banerjee, R. Adigopula, B. Underwood, F.E. Tanyingoh, D. Wei, S.C. Lin, W.C. Lin, H.H. Li, J. Bell, S. Niewiadomski, O. Kamm, M.A. Zeng, Z. Chen, M. Hu, P. Ong, D. Ooi, C.J. Ling, K. L. Miao, Y. Miao, J. de Silva, H.J. Niriella, M.A. Aniwan, S. Limsrivilai, J. Pisespongsa, P. Wu, K. Yang, H. Ng, K.K. Yu, H. H. Wang, Y. Ouyang, Q. Abdullah, M. Simadibrata, M. Gunawan, J. Hilmi, I. Goh, K. L. Cao, Q. Sheng, H. Ong-Go, A. Chong, V. H. Ching, J. Y. L. Wu, J. C. Y. Chan, F.K.L. Sung, J.J.Y. |
Keywords: | Bowel Disease |
Issue Date: | 2019 |
Publisher: | Wolters Kluwer Health |
Citation: | The American Journal of Gastroenterology. 2019;114(1):107-115 |
Abstract: | INTRODUCTION: Living in an urban environment may increase the risk of developing inflammatory bowel disease (IBD). It is unclear if this observation is seen globally. We conducted a population-based study to assess the relationship between urbanization and incidence of IBD in the Asia-Pacific region. METHODS: Newly diagnosed IBD cases between 2011 and 2013 from 13 countries or regions in Asia-Pacific were included. Incidence was calculated with 95% confidence interval (CI) and pooled using random-effects model. Meta-regression analysis was used to assess incidence rates and their association with population density, latitude, and longitude. RESULTS: We identified 1175 ulcerative colitis (UC), 656 Crohn's disease (CD), and 37 IBD undetermined (IBD-U). Mean annual IBD incidence per 100 000 was 1.50 (95% CI: 1.43-1.57). India (9.31; 95% CI: 8.38-10.31) and China (3.64; 95% CI, 2.97-4.42) had the highest IBD incidence in Asia. Incidence of overall IBD (incidence rate ratio [IRR]: 2.19; 95% CI: 1.01-4.76]) and CD (IRR: 3.28; 95% CI: 1.83-9.12) was higher across 19 areas of Asia with a higher population density. In China, incidence of IBD (IRR: 2.37; 95% CI: 1.10-5.16) and UC (IRR: 2.63; 95% CI: 1.2-5.8) was positively associated with gross domestic product. A south-to-north disease gradient (IRR: 0.94; 95% CI: 0.91-0.98) was observed for IBD incidence and a west-to-east gradient (IRR: 1.14; 95% CI: 1.05-1.24) was observed for CD incidence in China. This study received IRB approval. CONCLUSIONS: Regions in Asia with a high population density had a higher CD and UC incidence. Coastal areas within China had higher IBD incidence. With increasing urbanization and a shift from rural areas to cities, disease incidence may continue to climb in Asia. |
Description: | Indexed in MEDLINE |
URI: | http://repository.kln.ac.lk/handle/123456789/19293 |
ISSN: | 0002-9270 (Print) 1572-0241 (Electronic) |
Appears in Collections: | Journal/Magazine Articles |
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