以色列第一代移民中的炎症性肠病:全国范围内的以色列炎症性肠病研究核心(epi-Israeli Inflammatory Bowel Disease Research Nucleus)研究

Mira Y Stulman, G. Focht, Y. Loewenberg Weisband, S. Greenfeld, Amir Ben Tov, N. Ledderman, E. Matz, Ora Paltiel, S. Odes, Iris Dotan, Eric Ian Benchimol, Dan Turner
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摘要

背景 以色列的犹太人移民率很高,炎症性肠病(IBD)的发病率也很高。目的 比较第一代移民与以色列出生的犹太人的 IBD 患病率。方法 从经过验证的 epi-IIRN(以色列 IBD 研究核心)队列中纳入截至 2020 年 6 月诊断为 IBD 的患者,该队列包括 98% 的以色列人口。我们根据原籍国、移民时间和截至 2020 年 6 月的年龄组对移民队列进行了 IBD 风险分层。结果 共确定了 33544 名患者,其中 18524 人(55%)患有克罗恩病(CD),15020 人(45%)患有溃疡性结肠炎(UC);28394 人(85%)在以色列出生,5150 人(15%)为移民。溃疡性结肠炎在移民(2717 人,53%)中的发病率高于非移民(12303 人,43%,P < 0.001),尤其是在 < 1990 年的移民时期。在对年龄进行调整后,2020 年 6 月,在以色列居住时间越长,点患病率越高(高风险原籍:移民 < 1990 年:645.9/100000,≥ 1990 年:613.2/100000,P = 0.043;中/低风险原籍:移民 < 1990 年:540.5/100000,≥ 1990 年:613.2/100000,P = 0.043):< 1990: 540.5/100000, ≥ 1990: 192.0/100000, P < 0.001).来自IBD高风险国家的移民患者的患病率(561.4/100000)高于来自中/低风险国家的移民患者(514.3/100000;P < 0.001);非移民患者的患病率为528.9/100000。结论 我们发现,在以色列移民中,IBD 患病率随着移民时间的延长而增加,并与原籍国的 IBD 风险有关,这支持了环境对 IBD 病因学的影响。只有在较早移民的人群中,UC 的发病率才高于 CD。
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Inflammatory bowel disease among first generation immigrants in Israel: A nationwide epi-Israeli Inflammatory Bowel Disease Research Nucleus study
BACKGROUND Israel has a high rate of Jewish immigration and a high prevalence of inflammatory bowel disease (IBD). AIM To compare IBD prevalence in first-generation immigrants vs Israel-born Jews. METHODS Patients with a diagnosis of IBD as of June 2020 were included from the validated epi-IIRN (Israeli IBD Research Nucleus) cohort that includes 98% of the Israeli population. We stratified the immigration cohort by IBD risk according to country of origin, time period of immigration, and age group as of June 2020. RESULTS A total of 33544 patients were ascertained, of whom 18524 (55%) had Crohn’s disease (CD) and 15020 (45%) had ulcerative colitis (UC); 28394 (85%) were Israel-born and 5150 (15%) were immigrants. UC was more prevalent in immigrants (2717; 53%) than in non-immigrants (12303, 43%, P < 0.001), especially in the < 1990 immigration period. After adjusting for age, longer duration in Israel was associated with a higher point prevalence rate in June 2020 (high-risk origin: Immigration < 1990: 645.9/100000, ≥ 1990: 613.2/100000, P = 0.043; intermediate/low-risk origin: < 1990: 540.5/100000, ≥ 1990: 192.0/100000, P < 0.001). The prevalence was higher in patients immigrating from countries with high risk for IBD (561.4/100000) than those originating from intermediate-/low-risk countries (514.3/100000; P < 0.001); non-immigrant prevalence was 528.9/100000. CONCLUSION Lending support to the environmental effect on IBD etiology, we found that among immigrants to Israel, the prevalence of IBD increased with longer time since immigration, and was related to the risk of IBD in the country of origin. The UC rate was higher than that of CD only in those immigrating in earlier time periods.
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