Predicting complicated Crohn’s disease and surgery: phenotypes, genetics, serology and psychological characteristics of a population based cohort

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dc.contributor.authorRyan, John David
dc.contributor.authorSilverberg, Mark
dc.contributor.authorXu, Wei
dc.contributor.authorGraff, Lesley A.
dc.contributor.authorTargownik, Laura
dc.contributor.authorWalker, John R.
dc.contributor.authorCarr, Rachel
dc.contributor.authorClara, Ian
dc.contributor.authorMiller, Norine
dc.contributor.authorRogala, Linda
dc.contributor.authorBernstein, Charles N.
dc.date.accessioned2015-05-11T17:28:42Z
dc.date.available2015-05-11T17:28:42Z
dc.date.issued2012-08
dc.description.abstractBACKGROUND: Predictors of complicated Crohn's disease (CD), defined as stricturing or penetrating behaviour, and surgery have largely been derived from referral centre populations. AIM: To investigate whether serological markers, susceptibility genes or psychological characteristics are associated with complicated CD or surgery in a population-based cohort. METHODS: One hundred and eighty-two members of the Manitoba IBD Cohort with CD phenotyped using the Montreal classification underwent genetic and serological analysis at enrolment and after 5 years. One hundred and twenty-seven had paired sera at baseline and 5 years later and their data were used to predict outcomes at a median of 9.3 years. Serological analysis consisted of a seven antibody panel, and DNA was tested for CD-associated NOD2 variants (rs2066845,rs2076756,rs2066847), ATG16L1 (rs3828309, rs2241880) and IL23R (rs11465804). Psychological characteristics were assessed using semi-structured interviews and validated survey measures. RESULTS: Sixty-five per cent had complicated CD and 42% underwent surgery. Multivariate analysis indicated that only ASCA IgG-positive serology was predictive of stricturing/penetrating behaviour (OR = 3.01; 95% CI: 1.28-7.09; P = 0.01) and ileal CD (OR = 2.2; 95% CI: 1.07-4.54, P = 0.03). Complicated CD behaviour was strongly associated with surgery (OR = 5.6; 95% CI: 2.43-12.91; P < 0.0001), whereas in multivariate analysis, only ASCA IgG was associated (OR = 2.66; 95% CI, 1.40-5.06, P = 0.003). ASCA titre results were similar at baseline and follow-up. Psychological characteristics were not significantly associated with disease behaviour, serological profile or genotype. CONCLUSIONS: ASCA IgG at baseline was significantly associated with stricturing/penetrating disease at 9-10 years from diagnosis. Stricturing/penetrating disease was significantly associated with surgery. In a model including serology, the genotypes assessed did not significantly associate with complicated disease or surgery.en_US
dc.identifier.citationAliment Pharmacol Ther. 2013 Aug;38(3):274-83en_US
dc.identifier.doi10.1111/apt.12368
dc.identifier.urihttp://hdl.handle.net/1993/30418
dc.language.isoengen_US
dc.publisherAlimentary Pharmacology and Therapeuticsen_US
dc.relation.ispartofseries38(3);274-83
dc.rightsopen accessen_US
dc.subjectComplicateden_US
dc.subjectCrohn's Diseaseen_US
dc.subjectsurgeryen_US
dc.subjectphenotypesen_US
dc.subjectgeneticsen_US
dc.subjectBernsteinen_US
dc.titlePredicting complicated Crohn’s disease and surgery: phenotypes, genetics, serology and psychological characteristics of a population based cohorten_US
dc.typeArticleen_US
dc.typeDataseten_US
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