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Background and Aim: The global inflammatory bowel disease (IBD) escalation has precipitated an increased disease burden and economic impact, particularly in Asia. This study primarily aimed to predict the future prevalence of IBD in Korea and elucidate its evolution pattern. Methods: Using a validated diagnostic algorithm, we analyzed data from the Korean National Health Insurance Service between 2004 and 2017 to identify patients with IBD. We predicted the number and prevalence of patients with IBD from 2018 to 2048 with the autoregressive integrated moving average method. A generalized linear model (GLM) was also employed to identify factors contributing to the observed trend in IBD prevalence. Results: Our prediction model validation demonstrated an acceptable error range for IBD prevalence, with a 2.45% error rate and a mean absolute difference of 2.61. We foresee a sustained average annual increase of 4.51 IBD cases per 100 000, culminating in a prevalence of 239.73 per 100 000 by 2048. The forecasted average annual percent change was 6.17% for males and 2.75% for females over the next 30 years. The GLM analysis revealed that age, gender and time significantly impact the prevalence of IBD, with notable disparities observed between genders in specific age groups for both Crohn's disease and ulcerative colitis (all interaction P < 0.05). Conclusions: Our study forecasts a notable increase in Korean IBD prevalence by 2048, particularly among males and the 20–39 age group, highlighting the need to focus on these high‐risk groups to mitigate the future disease burden. [ABSTRACT FROM AUTHOR]

Background and Aims Crohn's disease [CD] has a complex polygenic aetiology with high heritability. There is ongoing effort to identify novel variants associated with susceptibility to CD through a genome-wide association study [GWAS] in large Korean populations. Methods Genome-wide variant data from 902 Korean patients with CD and 72 179 controls were used to assess the genetic associations in a meta-analysis with previous Korean GWAS results from 1621 patients with CD and 4419 controls. Epistatic interactions between CD-risk variants of interest were tested using a multivariate logistic regression model with an interaction term. Results We identified two novel genetic associations with the risk of CD near ZBTB38 and within the leukocyte immunoglobulin-like receptor [LILR] gene cluster [ p  < 5 × 10−8], with highly consistent effect sizes between the two independent Korean cohorts. CD-risk variants in the LILR locus are known quantitative trait loci [QTL] for multiple LILR genes, of which LILRB2 directly interacts with various ligands including MHC class I molecules. The LILR lead variant exhibited a significant epistatic interaction with CD-associated regulatory variants for TAP2 involved in the antigen presentation of MHC class I molecules [ p  = 4.11 × 10−4], showing higher CD-risk effects of the TAP2 variant in individuals carrying more risk alleles of the LILR lead variant (odds ratio [OR] = 0.941, p  = 0.686 in non-carriers; OR = 1.45, p  = 2.51 × 10−4 in single-copy carriers; OR = 2.38, p  = 2.76 × 10−6 in two-copy carriers). Conclusions This study demonstrated that genetic variants at two novel susceptibility loci and the epistatic interaction between variants in LILR and TAP2 loci confer a risk of CD. [ABSTRACT FROM AUTHOR]

Summary: Background: The association between antibiotic use and risk of inflammatory bowel disease (IBD), particularly among adults, remains unclear. Furthermore, there is a scarcity of data among non‐Western countries. Aims: To investigate the association and dose–response relationships between antibiotic use and subsequent IBD risk across all ages Methods: This population‐based case–control analysis used data from the Korean National Health Insurance Service database (2004–2018). We compared 68,633 patients with new‐onset IBD to matched controls (n = 343,165) using multivariable conditional logistic regression analysis. We also examined the dose–response relationship using non‐linear regression analysis, and separately analysed childhood‐onset IBD (aged ≤14 years) risk following early‐life antibiotic exposure. Results: The mean age at diagnosis was 45.2 ± 16.8 years. Antibiotic prescriptions between 2 and 5 years before diagnosis significantly increased the odds of developing IBD (adjusted odds ratio [OR], 1.24; 95% confidence interval [CI]: 1.21–1.27). Additionally, sensitivity analysis revealed an elevated risk up to 9 years before diagnosis. Broad‐spectrum antibiotics increased IBD risk, independent of gastroenteritis. A distinct dose–response relationship was observed irrespective of the IBD subtype and study population (all p < 0.001). Furthermore, antibiotic exposure within the first year of life was linked with the risk of childhood‐onset IBD (OR, 1.51; 95% CI: 1.25–1.82). Conclusions: Broad‐spectrum antibiotics dose‐dependently increased the risk for IBD in the Korean population. Our findings provide a fundamental epidemiological basis for identifying antibiotic use as a significant risk factor for IBD across different environmental backgrounds. [ABSTRACT FROM AUTHOR]