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Inflammatory bowel disease. An epidemiological and genetic study
1Department of Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden.
Acta Chirurgica Scandinavica. Supplementum
|January 1, 1990
Summary
This study investigated ulcerative colitis (UC) epidemiology in Stockholm County from 1955-1979. Incidence rose, then plateaued, with increased peak age of onset. Extracolonic diagnoses were more common in extensive colitis and familial UC.
Area of Science:
- Gastroenterology
- Epidemiology
- Genetics
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) with complex etiology.
- Understanding UC epidemiology, including incidence, prevalence, and risk factors, is crucial for public health management.
- Extracolonic manifestations and familial aggregation suggest a multifactorial disease model.
Purpose of the Study:
- To investigate the 25-year epidemiological trends of ulcerative colitis in Stockholm County.
- To determine the prevalence and characteristics of extracolonic diagnoses in UC patients.
- To explore the familial occurrence and genetic underpinnings of UC.
Main Methods:
- Retrospective population-based study of 1,274 UC cases from 1955-1979 in Stockholm County.
- Analysis of disease extent, time to diagnosis, incidence rates, and age at onset.
- Assessment of extracolonic diagnoses, familial IBD prevalence, and segregation analysis for genetic factors.
Main Results:
- UC incidence increased over the first 20 years, then plateaued at 4.3 per 10(5) inhabitants. Peak age of onset shifted to the 3rd and 4th decades.
- Extracolonic diagnoses were present in 21% of UC patients, significantly more common in extensive colitis (70% vs 28%).
- Familial IBD prevalence was 7.9%, with first-degree relatives showing a 15-fold higher UC risk. A rare additive major gene with low penetrance was suggested for UC etiology.
Conclusions:
- UC incidence in Stockholm County showed an increasing trend followed by a plateau, with a rising peak age of onset.
- Extracolonic manifestations are associated with disease extent and may be activity-related or autoimmune.
- UC exhibits significant familial aggregation, suggesting a strong genetic component, likely involving a major gene with low penetrance, rather than multifactorial inheritance.