Phenotypic Characterisation of Inflammatory Bowel Disease in South Asians in the United Kingdom: Insights into a Shifting Landscape
Notice bibliographique
Résumé
Purpose: The aetiology of inflammatory bowel disease (IBD) remains elusive; a complex interplay of genetic, environmental and immunological influences. The increasing incidence of IBD in developing countries and immigrant populations appears to outpace what genetic influences alone could instigate and may provide valuable insights into aetiology. There is a relative dearth of literature on the phenotypic characteristics of South Asian immigrant populations. The aim of our study was to define the clinical phenotype of IBD in South Asians living in North-West England. Methods: We conducted a retrospective study of 102 patients of South Asian origin attending IBD clinics at our hospital. Clinical data including demographics, disease characteristics (Montreal classification), treatment and blood results were obtained using electronic case records. Results: Of 102 patients reviewed, 54 were male. The median age was 38 years (range 16-80) and mean disease duration was 9.4 years. Seventy-three patients had ulcerative colitis (UC) and 29 had Crohn's disease (CD). Five patients were current or ex smokers (4.9%). Seventeen patients had extra-intestinal manifestations of IBD (16.7%). Of UC patients 35 had pancolitis, 33 left sided disease and 5 had proctitis. Of patients with CD, 3 had ileal disease, 10 colonic disease and 16 had ileocolonic disease. Five CD patients had stricturing disease, 10 had penetrating disease (6 also stricturing) and 14 had non-penetrating, non-stricturing disease. Perianal disease was noted in 3 at diagnosis and 5 subsequently developed it. Eighty patients received steroids, topical steroids (29), 5-ASA (96), topical 5-ASA (30), azathioprine (55), 6-mercaptopurine (4), cyclosporine (2), methotrexate (9), infliximab (20) and adalimumab (9). Fifty-seven patients received at least one immunomodulatory therapy with the median time to use being 12 months (range 0-276 mo). Thirteen patients (7 CD, 3 UC) required surgery (3 total colectomy, 10 subtotal). Mean time to surgery was 4 years (range 0-13 years). Seventeen patients had disease progression leading to Montreal reclassification (median time 60 months; range 1-216 mo). Conclusion: We noted a higher prevalence of UC with a predominance of pancolonic disease and a significant proportion of CD with penetrating or stricturing disease. The majority of patients required immunomodulatory therapy with the median time to use being only 12 months, suggesting a relatively more aggressive disease course. Epidemiologic insights from such populations may provide further clues in defining an aetiological paradigm for IBD and should form an important area of further research. A case control study exploring differences is underway at our institution.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».