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Evolutive trend of inflammatory bowel disease in sagunto (Valencia, Spain)
A1358 AGA ABSTRACTS
GASTROENTEROLOGY Vol. 118, No.4
6181
6183
TAP POLYMORPHISMS IN INFLAMMATORY BOWEL DISEASE. Ashley M. Miller, Peter R. Elliott, Brian D. Tait, Antony Ugoni, William Connell, Anthony Jf d' Apice, St Vincent's Hosp, Melbourne, Australia; Tissue Typing Lab, Royal Melbourne Hosp, Melbourne, Australia; Univ of Melbourne, Melbourne, Australia.
EVOLUTIVE TREND OF INFLAMMATORY BOWEL DISEASE IN SAGUNTO (VALENCIA, SPAIN). Jose R. Moles, Joaquin Hinojosa, Joaquin Primo, Carmen Gonzalez, Fernandez Julio, Pedro L1orca, Manuela Ramos, Hosp de Sagunto, Spain.
Background: Major Histocompatability Complex (MHC)-encoded genes, particularly HLA-DR, may confer susceptibility to inflammatory bowel disease (IBD). Located within the MHC class-II region are transporter associated with antigen processing (TAP) genes which encode for proteins involved in the transfer of antigenic peptides through the endoplasmic reticulum prior to their association with MHC class-I molecules. Four TAP 1 and eight TAP 2 alleles have been described in man. The aim of this study was to analyse polymorph isms of TAP genes in patients with ulcerative colitis (UC) or Crohn s disease(CD). Methods: 53 DC and 29 CD patients were assessed for TAPI and TAP2 gene polymorphisms and HLA DR alleles. Genotype and allelic frequency were compared to a previously published control population [I]. In addition, patients were divided into early onset «30 years of age) or late onset (>30 years of age) disease subgroups, and into two groups based on previous or current treatment for IBD (simple: corticosteroids or 5-aminosalicylic acid-based drugs, complex: azathioprine, methotrexate or cyclosporine). The allelism of the TAPI and TAP2 genes was investigated using a polymerase chain reaction-sequence specific primer method based on Powis et al [2]. Data was analysed using Fisher's exact test. Results: Patients with UC had a significantly decreased frequency of TAPI genotype AB (7.5% versus 19.1% of controls, p=0.05), TAPI B allele (3.8% versus 12.7% of controls, p
The inflammatory bowel disease (IBD) follows distinct patterns. Norther countries have the highest rates of the disease.by contrast countries in southern Europe have lower incidence rates. Howewer, it appears that, in Europe, southern countries are "catching up" to their northern neighbors. Aim:a) to analyze the IBD evolutive trend in our sanitary area (Sagunto.Spain), and b) to confirm the existence of northern and southern differences.. Methods:We performed a prospective and descriptive study of population, that covered the time included between the years 1990-98.AII the cases were detected, working the Hospital of Sagunto (123,000 persons) a center of reference.AlI the cases complied the diagnostic criteria of Lennard-Jones. We calculated the crude rates of incidence (CRI) and the truncated rate incidences for the population group between 15-64y in addition to the rate incidence adjusted (RIA) to the standard european population. Finally, we realized a tendency analysis of the respective incidence rates by method of simple regression, comparing the results of this period with results of a previous work that was realized in the same area (1983-1989). Results: I 15 patients were diagnosticated (72 ulcerative colitis,UC; 39 Crohn's disease,CD; and 4 indeterminate colitis). The results of CRI and RIA are expresed in the Table. If we compare the incidence between the two time periods,we observe a significative increase of UC incidence (6,52 vs 4,08 casesll 05 persons/y) and in global IBD too (l0,43 vs 7,15 cases/f O' persons/y), but not in CD (3,55 vs 3,01 cases/In" persons/y). The prevalence at the end of the study has been 63,30, 52,56 and 121,06 cases per 105 population for UC, CD and the global of IBD, respectively. Conclusions: IBD and UC particularly, is an illness of high incidence in Sagunto (Spain), with a clear increase tendence. We are attending at a progresssive reduction of nothernlsouthern difference, more obvious in CD.
CRI RIA RIA (15·64y)
UC
CO
IC
Global
6,52 6,42 8,61
3,55 3,56 5,05
0,36
10,43
6182
6184
GENETIC AND ENVIRONMENTAL FACTORS IN THE INFLAMMATORY BOWEL DISEASE: A STUDY CASES-CONTROLS. Jose R. Moles, Joaquin Hinojosa, Carmen Gonzalez, Joaquin Primo, Julio Fernandez, Pedro Llorca, Luis Garcia, Hosp de Sagunto, Valencia, Spain; Hosp de Valencia, Valencia, Spain. The inflammatory bowel disease (IBD) is an disease of unknown etiology. The relathionship between the environmental factors and genetic trends is being investigated for along time. Aim:a)to study the environmental factors of risk with possible effects in IBD, with special reference to smoking and oral contraceptives (OA); b)to study different genetic factors in IBD (familiar aggregation, HLA group, antineutrophil cytoplasmic antibodies with perinuclear staining (pANCA). Methods: Cases and controls type study of all incident cases with IBD and pertaining to our sanitary area (Sagunto,Spain)during the years 1990-1998.We detected all the possibles IBD cases (case-ascertainment)(l15 patients; 72 with ulcerative colitis [UC1, 39 with Crohn's disease [CD], and 4 with indeterminate colitis) being analysed only whose complied the diagnostic criteria of LennardJones.The controls (110 cases)came by patients of the same sanitary area, attended for functional bowel disease. All of them realized an epidemiologic inquiry, so pANCA and HLA were determinated in this way, using a voluntary group of blood donnor a control group.The statistical analysis has been realized with statistic test of Student and t· Results:We have only observed significative differences in the HLA-DR2 between patients with UC, CD and control group (p=0,02 and 0,004, respectively).The rest of the variables that presented some statistic and significative differences can be summed in the follow Table. Conclusions:I)The O.A. are significativelly associated with CD;2) the protecting effect of tobacco to UC and its nocive effect to CD is confirmed;3) both illness have an obvious genetic predisposition that is confirmed by the presence of a familiar positive aggregation;4) pANCA and HLA-DR2 are associated with UC in spanish poblation.
BONE MINERAL DENSITY MEASUREMENTS IN PATIENTS WITH CROHN'S DISEASE. Edit Molnar, Miklos Toth, Tamas Zagoni, Mark Juhasz, Andrea Nemetz, Agota Kovacs, Laszlo Pronai, Zsolt Tulassay, 2nd Dept of Int Med, Semmelweis Univ of Medicine, Budapest, Hungary; Erzsebet Hosp, Budapest, Hungary. Background: The pathomechanism, frequency and severity of low bone mineral density (BMD) in patients with inflammatory bowel disease (IBD) is not yet fully understood. Patients and methods: BMD measurements were performed by DEXA at the lumbar spine (LS, L2-L4), left femoral neck (FN), and the distal third of nondominant radius using a Hologic QDR 4500C instrument in 96 Crohn s disease (CD) patients and 189 healthy controls. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness were determined by Lunar Achilles Plus. The disease duration was 7.0 ::': 6,4 years (mean z SD) and we found the frequency of lifetime steroid usage 81.1 %. The frequency of small bowel resection, fistula development, extraintestinal manifestation and malabsortion during the disease history were 23, 21, 51 and 61 %, resp. Results: There were significant differences between BMD z-scores at LS (-1.03 ::': 1.10 vs. -0.18::':1.19, p
p
Tobacco O.A. Familiar ANCA
UC vs Control OR
0,001 0.330 0,009 <0,001
0,25 0,50 2,41 18.50
P
CO vs Control OR
0,004 0,158 0,006 0,25
3,06 2,20 3,63 2,55
P
COvsUC OR
0,007 0,003 0,884 0,001'
11,90 4,40 0,89 7.25'
GASTROENTEROLOGY Vol. 118, No.4
6181
6183
TAP POLYMORPHISMS IN INFLAMMATORY BOWEL DISEASE. Ashley M. Miller, Peter R. Elliott, Brian D. Tait, Antony Ugoni, William Connell, Anthony Jf d' Apice, St Vincent's Hosp, Melbourne, Australia; Tissue Typing Lab, Royal Melbourne Hosp, Melbourne, Australia; Univ of Melbourne, Melbourne, Australia.
EVOLUTIVE TREND OF INFLAMMATORY BOWEL DISEASE IN SAGUNTO (VALENCIA, SPAIN). Jose R. Moles, Joaquin Hinojosa, Joaquin Primo, Carmen Gonzalez, Fernandez Julio, Pedro L1orca, Manuela Ramos, Hosp de Sagunto, Spain.
Background: Major Histocompatability Complex (MHC)-encoded genes, particularly HLA-DR, may confer susceptibility to inflammatory bowel disease (IBD). Located within the MHC class-II region are transporter associated with antigen processing (TAP) genes which encode for proteins involved in the transfer of antigenic peptides through the endoplasmic reticulum prior to their association with MHC class-I molecules. Four TAP 1 and eight TAP 2 alleles have been described in man. The aim of this study was to analyse polymorph isms of TAP genes in patients with ulcerative colitis (UC) or Crohn s disease(CD). Methods: 53 DC and 29 CD patients were assessed for TAPI and TAP2 gene polymorphisms and HLA DR alleles. Genotype and allelic frequency were compared to a previously published control population [I]. In addition, patients were divided into early onset «30 years of age) or late onset (>30 years of age) disease subgroups, and into two groups based on previous or current treatment for IBD (simple: corticosteroids or 5-aminosalicylic acid-based drugs, complex: azathioprine, methotrexate or cyclosporine). The allelism of the TAPI and TAP2 genes was investigated using a polymerase chain reaction-sequence specific primer method based on Powis et al [2]. Data was analysed using Fisher's exact test. Results: Patients with UC had a significantly decreased frequency of TAPI genotype AB (7.5% versus 19.1% of controls, p=0.05), TAPI B allele (3.8% versus 12.7% of controls, p
The inflammatory bowel disease (IBD) follows distinct patterns. Norther countries have the highest rates of the disease.by contrast countries in southern Europe have lower incidence rates. Howewer, it appears that, in Europe, southern countries are "catching up" to their northern neighbors. Aim:a) to analyze the IBD evolutive trend in our sanitary area (Sagunto.Spain), and b) to confirm the existence of northern and southern differences.. Methods:We performed a prospective and descriptive study of population, that covered the time included between the years 1990-98.AII the cases were detected, working the Hospital of Sagunto (123,000 persons) a center of reference.AlI the cases complied the diagnostic criteria of Lennard-Jones. We calculated the crude rates of incidence (CRI) and the truncated rate incidences for the population group between 15-64y in addition to the rate incidence adjusted (RIA) to the standard european population. Finally, we realized a tendency analysis of the respective incidence rates by method of simple regression, comparing the results of this period with results of a previous work that was realized in the same area (1983-1989). Results: I 15 patients were diagnosticated (72 ulcerative colitis,UC; 39 Crohn's disease,CD; and 4 indeterminate colitis). The results of CRI and RIA are expresed in the Table. If we compare the incidence between the two time periods,we observe a significative increase of UC incidence (6,52 vs 4,08 casesll 05 persons/y) and in global IBD too (l0,43 vs 7,15 cases/f O' persons/y), but not in CD (3,55 vs 3,01 cases/In" persons/y). The prevalence at the end of the study has been 63,30, 52,56 and 121,06 cases per 105 population for UC, CD and the global of IBD, respectively. Conclusions: IBD and UC particularly, is an illness of high incidence in Sagunto (Spain), with a clear increase tendence. We are attending at a progresssive reduction of nothernlsouthern difference, more obvious in CD.
CRI RIA RIA (15·64y)
UC
CO
IC
Global
6,52 6,42 8,61
3,55 3,56 5,05
0,36
10,43
6182
6184
GENETIC AND ENVIRONMENTAL FACTORS IN THE INFLAMMATORY BOWEL DISEASE: A STUDY CASES-CONTROLS. Jose R. Moles, Joaquin Hinojosa, Carmen Gonzalez, Joaquin Primo, Julio Fernandez, Pedro Llorca, Luis Garcia, Hosp de Sagunto, Valencia, Spain; Hosp de Valencia, Valencia, Spain. The inflammatory bowel disease (IBD) is an disease of unknown etiology. The relathionship between the environmental factors and genetic trends is being investigated for along time. Aim:a)to study the environmental factors of risk with possible effects in IBD, with special reference to smoking and oral contraceptives (OA); b)to study different genetic factors in IBD (familiar aggregation, HLA group, antineutrophil cytoplasmic antibodies with perinuclear staining (pANCA). Methods: Cases and controls type study of all incident cases with IBD and pertaining to our sanitary area (Sagunto,Spain)during the years 1990-1998.We detected all the possibles IBD cases (case-ascertainment)(l15 patients; 72 with ulcerative colitis [UC1, 39 with Crohn's disease [CD], and 4 with indeterminate colitis) being analysed only whose complied the diagnostic criteria of LennardJones.The controls (110 cases)came by patients of the same sanitary area, attended for functional bowel disease. All of them realized an epidemiologic inquiry, so pANCA and HLA were determinated in this way, using a voluntary group of blood donnor a control group.The statistical analysis has been realized with statistic test of Student and t· Results:We have only observed significative differences in the HLA-DR2 between patients with UC, CD and control group (p=0,02 and 0,004, respectively).The rest of the variables that presented some statistic and significative differences can be summed in the follow Table. Conclusions:I)The O.A. are significativelly associated with CD;2) the protecting effect of tobacco to UC and its nocive effect to CD is confirmed;3) both illness have an obvious genetic predisposition that is confirmed by the presence of a familiar positive aggregation;4) pANCA and HLA-DR2 are associated with UC in spanish poblation.
BONE MINERAL DENSITY MEASUREMENTS IN PATIENTS WITH CROHN'S DISEASE. Edit Molnar, Miklos Toth, Tamas Zagoni, Mark Juhasz, Andrea Nemetz, Agota Kovacs, Laszlo Pronai, Zsolt Tulassay, 2nd Dept of Int Med, Semmelweis Univ of Medicine, Budapest, Hungary; Erzsebet Hosp, Budapest, Hungary. Background: The pathomechanism, frequency and severity of low bone mineral density (BMD) in patients with inflammatory bowel disease (IBD) is not yet fully understood. Patients and methods: BMD measurements were performed by DEXA at the lumbar spine (LS, L2-L4), left femoral neck (FN), and the distal third of nondominant radius using a Hologic QDR 4500C instrument in 96 Crohn s disease (CD) patients and 189 healthy controls. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness were determined by Lunar Achilles Plus. The disease duration was 7.0 ::': 6,4 years (mean z SD) and we found the frequency of lifetime steroid usage 81.1 %. The frequency of small bowel resection, fistula development, extraintestinal manifestation and malabsortion during the disease history were 23, 21, 51 and 61 %, resp. Results: There were significant differences between BMD z-scores at LS (-1.03 ::': 1.10 vs. -0.18::':1.19, p
p
Tobacco O.A. Familiar ANCA
UC vs Control OR
0,001 0.330 0,009 <0,001
0,25 0,50 2,41 18.50
P
CO vs Control OR
0,004 0,158 0,006 0,25
3,06 2,20 3,63 2,55
P
COvsUC OR
0,007 0,003 0,884 0,001'
11,90 4,40 0,89 7.25'