Inflammatory bowel disease characteristics among African Americans, Hispanics, and non-Hispanic Whites: characterization of a large North American cohort.
OBJECTIVE
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.
Nguyen
Geoffrey C
GC
Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Torres
Esther A
EA
Regueiro
Miguel
M
Bromfield
Gillian
G
Bitton
Alain
A
Stempak
Joanne
J
Dassopoulos
Themistocles
T
Schumm
Philip
P
Gregory
Federico J
FJ
Griffiths
Anne M
AM
Hanauer
Stephen B
SB
Hanson
Jennifer
J
Harris
Mary L
ML
Kane
Sunanda V
SV
Orkwis
Heather Kiraly
HK
Lahaie
Raymond
R
Oliva-Hemker
Maria
M
Pare
Pierre
P
Wild
Gary E
GE
Rioux
John D
JD
Yang
Huiying
H
Duerr
Richard H
RH
Cho
Judy H
JH
Steinhart
A Hillary
AH
Brant
Steven R
SR
Silverberg
Mark S
MS
D000328:Adult; D001741:Black or African American; D003093:Colitis, Ulcerative; D003108:Colonic Diseases; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology; D004378:Duodenal Diseases; D004893:Erythema Nodosum / Q000150:complications; D004935:Esophageal Diseases; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008913:Minority Groups; D015995:Prevalence; D012002:Rectal Diseases; D012446:Sacroiliac Joint; D013272:Stomach Diseases; D014481:United States; D014605:Uveitis / Q000209:etiology; D044465:White People