Inflammatory Bowel Disease Characteristics Among African Americans, Hispanics, and Non-Hispanic Whites: Characterization of a Large North American Cohort

Authors: Nguyen, Geoffrey C.¹; Torres, Esther A.²; Regueiro, Miguel³; Bromfield, Gillian⁴; Bitton, Alain⁵; Stempak, Joanne⁶; Dassopoulos, Themistocles¹; Schumm, Philip⁴; Gregory, Federico J.²; Griffiths, Anne M.⁷; Hanauer, Stephen B.⁴; Hanson, Jennifer³; Harris, Mary L.¹; Kane, Sunanda V.⁴; Orkwis, Heather Kiraly³; Lahaie, Raymond⁸; Oliva-Hemker, Maria⁹; Pare, Pierre¹⁰; Wild, Gary E.¹¹; Rioux, John D.; Yang, Huiying¹²; Duerr, Richard H.; Cho, Judy H.⁴; Steinhart, A. Hillary⁶; Brant, Steven R.; Silverberg, Mark S.⁶

Source: The American Journal of Gastroenterology, Volume 101, Number 5, May 2006 , pp. 1012-1023(12)

Publisher: Blackwell Publishing

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Abstract:

OBJECTIVES: Inflammatory bowel disease (IBD), comprising primarily of Crohn's disease (CD) and ulcerative colitis (UC), is increasingly prevalent in racial and ethnic minorities. This study was undertaken to characterize racial differences in disease phenotype in a predominantly adult population.

METHODS: Phenotype data on 830 non-Hispanic white, 127 non-Hispanic African American, and 169 Hispanic IBD patients, recruited from six academic centers, were abstracted from medical records and compiled in the NIDDK-IBD Genetics Consortium repository. We characterized racial differences in family history, disease location and behavior, surgical history, and extraintestinal manifestations (EIMs) using standardized definitions.

RESULTS: African American CD patients were more likely than whites to develop esophagogastroduodenal CD (OR = 2.8; 95% CI: 1.4–5.5), colorectal disease (OR = 1.9; 95% CI: 1.1–3.4), perianal disease (OR = 1.7; 95% CI: 1.03–2.8), but less likely to have ileal involvement (OR = 0.55; 95% CI: 0.32–0.96). They were also at higher risk for uveitis (OR = 5.5; 95% CI: 2.3–13.0) and sacroiliitis (OR = 4.0; 95% CI: 1.55–10.1). Hispanics had higher prevalence of perianal CD (OR = 2.9; 95% CI: 1.8–4.6) and erythema nodosum (3.3; 95% CI: 1.7–6.4). Among UC patients, Hispanics had more proximal disease extent. Both African American and Hispanic CD patients, but not UC patients, had lower prevalences of family history of IBD than their white counterparts.

CONCLUSIONS: There are racial differences in IBD family history, disease location, and EIMs that may reflect underlying genetic variations and have important implications for diagnosis and management of disease. These findings underscore the need for further studies in minority populations.

(Am J Gastroenterol 2006;101:1012–1023)

Document Type: Research article

DOI: 10.1111/j.1572-0241.2006.00504.x

Affiliations: 1: Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 2: Department of Medicine, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico 3: Inflammatory Bowel Disease Center and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 4: The University of Chicago, Chicago, Illinois 5: Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada 6: Department of Medicine, Mount Sinai Hospital Inflammatory Bowel Disease Centre, University of Toronto, Toronto, Canada 7: Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada 8: Hôpital St. Luc, Centre Hospitalier, Université de Montréal, Quebec, Canada 9: Pediatric Gastroenterology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 10: Hôpital du Saint-Sacrement, Quebec, Canada 11: Montreal General Hospital, McGill University, Quebec, Canada 12: Division of Medical Genetics and Inflammatory Bowel Disease Center, Cedar-Sinai Medical Center, Los Angeles, California

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