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Gender differences in paediatric patients of the swiss inflammatory bowel disease cohort study
Denise Herzog1, Patrick Buehr2, Rebekka Koller2
1Division of Gastroenterology, Department of Paediatrics, Cantons Hospital of Fribourg, Fribourg, Switzerland.
Insights
Crohn
Area of Science:
- Pediatric gastroenterology
- Inflammatory bowel disease research
- Pediatric IBD epidemiology
Background:
- Gender disparities in pediatric inflammatory bowel disease (IBD) are inconsistently reported.
- Previous studies show divergent findings regarding sex differences in IBD.
- A systematic approach is needed to clarify these gender differences.
Purpose of the Study:
- To investigate gender differences in pediatric patients diagnosed with IBD.
- To analyze data from the Swiss IBD cohort study (since 2008).
- To apply the Montreal classification for systematic assessment of gender-related IBD variations.
Main Methods:
- Retrieved and analyzed data from 196 pediatric IBD patients.
- Included data on gender, age, anthropometrics, disease location, behavior, and therapy.
- Classified patients into Crohn's disease (CD) and ulcerative/indeterminate colitis (UC/IC) groups.
Main Results:
- In children under 10, Crohn's disease showed a male predominance (crude ratio 2.57:1).
- Ulcerative colitis/indeterminate colitis in children under 10 had a female predominance (ratio 0.68:1).
- Boys with UC/IC diagnosed <10 years experienced longer diagnostic delays; girls diagnosed >10 years used azathioprine more.
Conclusions:
- Crohn's disease in pre-pubertal children (<10 years) predominantly affects boys.
- Further research into the role of sex hormones in pediatric CD development is warranted.
- No significant gender differences were observed in disease location, behavior, or treatment beyond specific age groups.
Purpose:
Gender differences in paediatric patients with inflammatory bowel disease (IBD) are frequently reported as a secondary outcome and the results are divergent. To assess gender differences by analysing data collected within the Swiss IBD cohort study database since 2008, related to children with IBD, using the Montreal classification for a systematic approach.
Methods:
Data on gender, age, anthropometrics, disease location at diagnosis, disease behaviour, and therapy of 196 patients, 105 with Crohn's disease (CD) and 91 with ulcerative or indeterminate colitis (UC/IC) were retrieved and analysed.
Results:
THE CRUDE GENDER RATIO (MALE : female) of patients with CD diagnosed at <10 years of age was 2.57, the adjusted ratio was 2.42, and in patients with UC/IC it was 0.68 and 0.64 respectively. The non-adjusted gender ratio of patients diagnosed at ≥10 years was 1.58 for CD and 0.88 for UC/IC. Boys with UC/IC diagnosed <10 years of age had a longer diagnostic delay, and in girls diagnosed with UC/IC >10 years a more important use of azathioprine was observed. No other gender difference was found after analysis of age, disease location and behaviour at diagnosis, duration of disease, familial occurrence of IBD, prevalence of extra-intestinal manifestations, complications, and requirement for surgery.
Conclusion:
CD in children <10 years affects predominantly boys with a sex ratio of 2.57; the impact of sex-hormones on the development of CD in pre-pubertal male patients should be investigated.
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