title: Family history and disease outcomes in patients with Crohn's disease: A comparison between China and the United States.
abstract: OBJECTIVE
  To investigate the differences in family history of inflammatory bowel disease (IBD) and clinical outcomes among individuals with Crohn's disease (CD) residing in China and the United States.
  
  
  METHODS
  We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States. We compared the prevalence of IBD family history and history of ileal involvement, CD-related surgeries and IBD medications in China and the United States, adjusting for potential confounders.
  
  
  RESULTS
  We recruited 49 participants from China and 145 from the United States. The prevalence of family history of IBD was significantly lower in China compared with the United States (China: 4.1%, United States: 39.3%). The three most commonly affected types of relatives were cousin, sibling, and parent in the United States compared with child and sibling in China. Ileal involvement (China: 63.3%, United States: 63.5%) and surgery for CD (China: 51.0%, United States: 49.7%) were nearly equivalent in the two countries.
  
  
  CONCLUSIONS
  The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States. Despite the potential difference in etiology, surgery and ileal involvement were similar in the two countries. Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Pei-Qi
authors.initials: PQ
authors.lastname: Wang
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Jun
authors.initials: J
authors.lastname: Hu
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Elie S
authors.initials: ES
authors.lastname: Al Kazzi
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Eboselume
authors.initials: E
authors.lastname: Akhuemonkhan
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Min
authors.initials: M
authors.lastname: Zhi
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Raquel Holand
authors.initials: RH
authors.lastname: de Paula Pessoa
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Sami
authors.initials: S
authors.lastname: Ghazaleh
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Tuhina
authors.initials: T
authors.lastname: Cornelius
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Suhel Abbas
authors.initials: SA
authors.lastname: Sabunwala
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Shadi
authors.initials: S
authors.lastname: Ghadermarzi
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Kartikeya
authors.initials: K
authors.lastname: Tripathi
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Mark
authors.initials: M
authors.lastname: Lazarev
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Pin-Jin
authors.initials: PJ
authors.lastname: Hu
authors.affiliation: Pei-Qi Wang, Eboselume Akhuemonkhan, Shadi Ghadermarzi, Mark Lazarev, Susan Hutfless, Department of Medicine, Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Hutfless
keywords: Crohn’s disease; Disease outcome; Environment; Epidemiology; Family history; Inflammatory bowel disease; Medication; Surgery; genetics