Men and Women Have Different Risks for EIMs in Inflammatory Bowel Disease
A recent study published in Clinical Gastroenterology and Hepatology aimed to evaluate sex-based differences in the presentation and progression of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC).
Data were derived from the Spanish Estudio Nacional en Enfermedad Inflamatoria intestinal sobre Determinantes genéticos y Ambientales registry, with data extraction in July 2021. A total of 51,595 patients with IBD were included, 52% of whom were men. Among them, 25,947 had CD. The median follow-up was 9 years for men and 10 years for women.
For patients with CD, female sex was independently associated with disease onset at age 17–40 years (relative risk ratio [RRR], 1.45; 95% confidence interval [CI], 1.31–1.62) and age >40 years (RRR, 1.55; 95% CI, 1.38–1.73). Women were more likely to have exclusive colonic involvement (odds ratio [OR], 1.24; 95% CI, 1.14–1.34), inflammatory behavior (OR, 1.14; 95% CI, 1.07–1.21), and extraintestinal manifestations (OR, 1.48; 95% CI, 1.38–1.59). Conversely, female sex was a protective factor against upper gastrointestinal involvement (OR, 0.84; 95% CI, 0.79–0.90), penetrating behavior (OR, 0.76; 95% CI, 0.70–0.82), perianal disease (OR, 0.77; 95% CI, 0.71–0.82), and complications (OR, 0.73; 95% CI, 0.66–0.80).
In UC, women had a higher risk of extraintestinal manifestations (OR, 1.48; 95% CI, 1.26–1.61) but were protected against disease onset after age 40 (RRR, 0.76; 95% CI, 0.66–0.87), left-sided colonic involvement (RRR, 0.72; 95% CI, 0.67–0.78), extensive colonic involvement (RRR, 0.59; 95% CI, 0.55–0.64), and abdominal surgery (OR, 0.78; 95% CI, 0.69–0.88).
This study highlights the need to consider sex in clinical management, the authors concluded.
Reference
Gargallo-Puyuelo CJ, Ricart E, Iglesias E, de Francisco R, et al. Sex-related differences in the phenotype and course of inflammatory bowel disease: SEXEII study of ENEIDA. Clin Gastroenterol Hepatol. Published online May 22, 2024. doi: 10.1016/j.cgh.2024.05.013.
