Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Jul 14, 2026; 32(26): 118595
Published online Jul 14, 2026. doi: 10.3748/wjg.118595
Published online Jul 14, 2026. doi: 10.3748/wjg.118595
Risk factors and fatigue in difficult-to-treat Crohn’s disease: A cross-sectional study of a Chinese cohort
Zhi Wu, Zhi-Wei Huang, Zhi-Jun Cao, Ying Sun, Xin-Xian Zhao, Wen-Fang Xu, Sheng-Liang Chen, Shu-Liang Zhao, Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, NHC Key Laboratory of Digestive Diseases, State Key Laboratory for Oncogenes and Related Genes, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai 200001, China
Yue Zhang, Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
Co-first authors: Zhi Wu and Zhi-Wei Huang.
Co-corresponding authors: Yue Zhang and Shu-Liang Zhao.
Author contributions: Wu Z drafted the article; Wu Z and Huang ZW performed the data analyses and contributed to the visualization as co-first authors; Wu Z, Cao ZJ, Chen SL, Zhang Y, and Zhao SL revised the article; Cao ZJ, Chen SL, and Zhao SL designed and supervised the study; Cao ZJ, Zhang Y and Zhao SL contributed to funding acquisition; Sun Y, Zhao XX and Xu WF collected the data; Zhang Y and Zhao SL contributed to statistical and analytic support as co-corresponding authors; and all authors have read and approved the final manuscript.
Supported by “Science and Technology Innovation Action Plan” Medical Innovation Research Project of Shanghai Municipal Science and Technology Commission, No. 22Y11907900.
Institutional review board statement: The study’s protocol was reviewed and approved by the Ethics Committee of Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital (No. LY2025-003-B).
Informed consent statement: Ethical approval for this retrospective cohort study was obtained with a waiver of informed consent.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Data sharing statement: Data are available upon reasonable request.
Corresponding author: Shu-Liang Zhao, MD, PhD, Division of Gastroenterology and Hepa
Received: January 8, 2026
Revised: February 4, 2026
Accepted: April 2, 2026
Published online: July 14, 2026
Processing time: 170 Days and 9.7 Hours
Revised: February 4, 2026
Accepted: April 2, 2026
Published online: July 14, 2026
Processing time: 170 Days and 9.7 Hours
Core Tip
Core Tip: This study applied the international difficult-to-treat (DTT) inflammatory bowel disease criteria to a Chinese cohort of Crohn’s disease (CD) patients. There was a high prevalence of DTT-CD, primarily driven by complex perianal disease. We identified elevated serum interleukin-5 and interleukin-10 as independent risk factors for DTT-CD even after adjustment for disease activity, suggesting a distinct immunophenotype. DTT-CD was associated with a significantly higher level of mental fatigue.