Publication Name	World Journal of Gastroenterology
Manuscript ID	118595
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Cohort Study
Article Title	Risk factors and fatigue in difficult-to-treat Crohn's Disease: A cross-sectional study of a Chinese cohort
Manuscript Source	Unsolicited Manuscript
All Author List	Zhi Wu, Zhi-Wei Huang, Zhi-Jun Cao, Ying Sun, Xin-Xian Zhao, Wen-Fang Xu, Sheng-Liang Chen, Yue Zhang and Shu-Liang Zhao
Funding Agency and Grant Number	Funding Agency Grant Number “Science and Technology Innovation Action Plan” Medical Innovation Research Project of Shanghai Municipal Science and Technology Commission No. 22Y11907900
Corresponding Author	Shu-Liang Zhao, MD, PhD, 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, No. 160 Pujian Road, Pudong New Area, Shanghai 200001, China. zhaosl@sjtu.edu.cn
Key Words	Difficult-to-treat; Inflammatory bowel disease; Fatigue; Crohn’s disease; Cross-sectional study
Core Tip	This study applied the international DTT-IBD criteria to a Chinese Crohn's disease (CD) cohort, revealing a high prevalence of difficult-to-treat CD (DTT-CD), primarily driven by complex perianal disease. We identified elevated serum IL-5 and IL-10 as independent risk factors for DTT-CD even after adjustment of disease activity, suggesting a distinct immune phenotype. Furthermore, DTT-CD was associated with significantly higher levels of patient-reported mental fatigue.
Citation	Wu Z, Huang ZW, Cao ZJ, Sun Y, Zhao XX, Xu WF, Chen SL, Zhang Y, Zhao SL. Risk factors and fatigue in difficult-to-treat Crohn’s disease: A cross-sectional study of a Chinese cohort. World J Gastroenterol 2026; In press

Received	2026-01-08 07:20
Peer-Review Started	2026-01-08 07:20
First Decision by Editorial Office Director	2026-01-23 10:04
Return for Revision	2026-01-23 10:04
Revised	2026-02-04 10:33
Publication Fee Transferred	2026-02-08 13:45
Second Decision by Editor	2026-04-02 02:37
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-02 08:31
Articles in Press	2026-04-02 08:31
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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