Prevalence and clinical profiles of primary sclerosing cholangitis in China: Data from electronic medical records and systematic literature retrieval

• Published in: Journal of autoimmunity 2024-07, Vol.147, p.103264, Article 103264
• Main Authors: Xu, Xiaoqian, Meng, Tongtong, Shi, Lichen, Duan, Weijia, Niu, Junqi, Ding, Huiguo, Xie, Wen, Zhou, Lu, Wang, Bangmao, Li, Jie, Zhang, Lingyi, Wang, Yu, Ou, Xiaojuan, Zhao, Xinyan, You, Hong, Jia, Jidong, Kong, Yuanyuan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Child; China - epidemiology; Cholangitis, Sclerosing - epidemiology; Clinical course; Electronic Health Records; Female; Humans; Inflammatory Bowel Diseases - epidemiology; Male; Middle Aged; Prevalence; Primary sclerosing cholangitis; Survival; Young Adult
• ISSN: 0896-8411; 1095-9157; 1095-9157
• DOI: 10.1016/j.jaut.2024.103264

Epidemiology of primary sclerosing cholangitis (PSC) is lacking in China. We aimed to estimate the period prevalence and depict the clinical features of PSC in China. We identified and included PSC cases between 2000 and 2023 from two sources: electronic medical records (EMR) and systematical literature retrieval (SLR). The period prevalence of PSC was estimated by the multiplier method. Rate ratios (RRs) for PSC prevalence in relation to macroeconomic indicators were calculated by the negative binomial regression model. A total of 1358 PSC cases were retrieved from 299 hospitals (162 from EMR and 1196 from SLR). Males accounted for 55.7 % of the PSC cases and 25.7 % had concomitant inflammatory bowel disease (IBD). The estimated period prevalence of PSC from 2000 to 2023 was 2.36 (95 % CI: 1.82, 3.34) per 100,000. Males had a numerically higher PSC prevalence than females (2.56, 95 % CI: 1.97, 3.63 vs. 2.14, 95 % CI: 1.65, 3.04 per 100,000). The highest prevalence of PSC was in East China at 4.87 (95 % CI: 3.44, 7.18) per 100,000, followed by North China at 2.94 (95 % CI: 2.33, 3.74) per 100,000, and the lowest in South China at 0.92 (95 % CI: 0.66, 1.30) per 100,000. Regional per capita GDP (RR 1.65, 95 % CI: 1.03, 2.65) and healthcare expenditure (RR 1.94, 95 % CI: 1.13, 3.38) were identified to be associated with PSC prevalence. Our study showed the estimated PSC prevalence varied within China, but was generally lower than that in Western countries. •Epidemiology of primary sclerosing cholangitis (PSC) is lacking in China.•The estimated period prevalence of PSC in China from 2000 to 2023 was 2.36 per 100,000, lower than that in Western countries.•PSC prevalence was higher in males and in more economically developed areas in China.•Male predominance was less apparent and concomitant IBD was less frequent in Chinese patients with PSC.