title: Clinical presentation and disease course of inflammatory bowel disease differs by race in a large tertiary care hospital.
abstract: BACKGROUND
  While the incidence of inflammatory bowel disease (IBD) among African-Americans (AAs) is increasing, there is limited understanding of phenotypic differences and outcomes by race.
  
  
  OBJECTIVE
  To describe disease characteristics of AA patients compared to Caucasian (Ca) patients in a tertiary care population.
  
  
  METHODS
  We performed a cross-sectional review of the IBD registry at the University of Chicago from January 2008 to January 2013. Data regarding race, phenotype, disease onset, disease duration, medical therapy, and surgical treatment were abstracted from the database, then compared via Pearson's chi-square analysis, Kruskal-Wallis analysis, and logistic regression with a significance level of p < 0.05.
  
  
  RESULTS
  A total of 1,235 patients with Crohn's disease (CD) and 541 patients with ulcerative colitis (UC) included 108 AA CD patients and 28 AA UC patients. AA CD patients had an increased rate of IBD-related arthralgias (36.5 vs. 23.9 %, p < 0.01) and surgery (p < 0.01), less ileal involvement (57.8 vs. 71.0 %, p < 0.01), and no differences for other extraintestinal manifestations or disease locations compared to Ca CD patients. AA UC patients were older at diagnosis, had an increased rate of arthralgias (28.6 vs. 14.6 %, p = 0.047) and ankylosing spondylitis/sacroiliitis (7.1 vs. 1.6 %, p = 0.035), with no differences for disease extent or rate of IBD-related surgeries compared to Ca UC patients. There were no differences in medication usage by race for CD and UC patients.
  
  
  CONCLUSIONS
  We identified significant differences in disease characteristics and extraintestinal manifestations between AA and Ca IBD patients in a large tertiary care population. These results have implications for future genotype-phenotype studies.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA, masofia@uchicago.edu.
authors.forename: M Anthony
authors.initials: MA
authors.lastname: Sofia
authors.forename: David T
authors.initials: DT
authors.lastname: Rubin
authors.forename: Ningqi
authors.initials: N
authors.lastname: Hou
authors.forename: Joel
authors.initials: J
authors.lastname: Pekow
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D018771:Arthralgia / Q000208:ethnology; D002641:Chicago / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000208:ethnology* / Q000601:surgery; D003424:Crohn Disease / Q000188:drug therapy / Q000208:ethnology* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012042:Registries; D058566:Sacroiliitis / Q000208:ethnology; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000208:ethnology; D062606:Tertiary Care Centers; D044465:White People; D055815:Young Adult
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