For the first time, Gut published epidemiological data on inflammatory bowel disease in men with high-risk same-sex sexual behavior

Inflammatory bowel disease (IBD) is a class of chronic nonspecific inflammatory diseases of the intestine, mainly including ulcerative colitis (UC) and Crohn's disease (CD
).

Globally, the incidence of IBD is on the rise year by year, with the prevalence exceeding 0.

The site of IBD onset is indicated

In the past 20 years, the LGBTQIA+ community has grown in the United States (L for lesbian, G for gay, B for bisexuals, T for transgender, Q for sex-scrupulous, I for intersex, A for asexuals), and by 2022, it will account for 7.

On September 1, 2022, Gut, a leading journal in the field of digestion, published the results of an IBD study of LGBTQIA+ people in the United States[3], completed by the Case Western Reserve University's Institute of Digestive Health, which for the first time disclosed epidemiological data
on IBD in men with high-risk same-sex sexual behavior.

They found that the incidence of IBD in men with high-risk same-sex sex was significantly higher than that of men with high-risk heterosexual sex, more than 2-fold, suggesting that high-risk male sexual behavior may be a new risk factor for
IBD.

The study is based on Case Western Reserve University's retrospective analysis
of medical data from 58 U.

At the beginning of the study, the researchers first included adults with a clear sexual orientation in the cohort, including heterosexuals and homosexuals, excluding bisexuality, and then performed prevalence statistics and subgroup analyses
of homosexual and heterosexual groups based on the prevalence of IBD and whether CD or UC was diagnosed.

The results of the study showed that a total of 11,845 adults had engaged in high-risk same-sex sexual activity, of which 91 (0.

Of the 10,795 men who had high-risk same-sex sexual intercourse, 86 cases were diagnosed with CD, accounting for 0.

In the same period, there were 60,755 men who had high-risk heterosexual sex, 298 cases were diagnosed with CD, accounting for 0.

This suggests that high-risk same-sex sex doubles men's risk of IBD compared to high-risk heterosexual sex, with CD and UC increasing their risk by 64% and 145%,
respectively.

General situation of high-risk heterosexual men with IBD and high-risk men with same-sex sex with IBD

In the subgroup analysis, the researchers also found that among CD patients, men with high-risk same-sex sex were more likely to have perianal diseases, including perianal and rectal abscesses, as well as colon and small bowel diseases
.

Compared with healthy people, patients with IBD have abnormalities in the intestinal flora, which is an important trigger factor in the process of intestinal immune damage [4
].

Previous studies have shown [5] that the gut flora of men who have sex with men is richer and more diverse than that of men and women who have sex, with same-sex men having a rich gut rich in Prevotella, while the intestines of heterosexual men are mostly rich in Bacteroides
.

In addition, because the peak age of infection with CD and the peak age of infection of sexually transmitted diseases were observed, the researchers also considered the sexual transmission
of gut microbes between individuals.

Professor Fabio Cominelli, Leader of the Research Group and Head of the Department of Gastroenterology, Case Western Reserve University

All in all, as Fabio Cominelli, director of the Department of Gastroenterology at Case Western Reserve University, the initiator of this study, said, "This is the first IBD cohort study
based on a large LGBTQIA+ population.

The project has been tapped with additional research funding
from the National Institutes of Health (NIH).
It is understood that researchers are currently conducting prospective studies to further confirm the increase in the prevalence of IBD in high-risk same-sex sex men, the relationship between specific sexual behavior and the risk of CD and UC onset, through plasma, tissue and fecal samples and gut microbiome analysis of LGBTQIA+ populations to explore the potential role and detailed mechanism of intestinal flora in the onset of
IBD.

The researchers believe that this study is expected to open up a new field of research for IBD, further elucidate the development of IBD, and develop personalized precision medicine and treatment strategies, while helping to eliminate the disease stigma
of the LGBTQIA+ community.

References

[1] GBD 2017 Inflammatory Bowel Disease Collaborators.
The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.
Lancet Gastroenterol Hepatol.
2020; 5(1):17-30.
doi:10.
1016/S2468-1253(19)30333-4

[2] Ng SC, Shi HY, Hamidi N, et al.
Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies.
Lancet.
2017; 390(10114):2769-2778.
doi:10.
1016/S0140-6736(17)32448-0

[3] Mansoor E, Martin SA, Perez A, et al.
Epidemiology of inflammatory bowel disease in men with high-risk homosexual activity.
Gut[Epub ahead of print].
doi:10.
1136/gutjnl-2022-328218

[4] Nishida A, Inoue R, Inatomi O, Bamba S, Naito Y, Andoh A.
Gut microbiota in the pathogenesis of inflammatory bowel disease.
Clin J Gastroenterol.
2018; 11(1):1-10.
doi:10.
1007/s12328-017-0813-5

[5] Noguera-Julian M, Rocafort M, Guillén Y, et al.
Gut Microbiota Linked to Sexual Preference and HIV Infection.
EBioMedicine.
2016; 5:135-146.
Published 2016 Jan 28.
doi:10.
1016/j.
ebiom.
2016.
01.
032

[6] Segal AW.
Making sense of the cause of crohn’s - a new look at an old disease.
F1000Res 2016; 5:2510.

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