title: High prevalence of inflammatory bowel disease in United States residents of Indian ancestry.
abstract: OBJECTIVE
  It is unclear whether the reported low prevalence of inflammatory bowel disease (IBD) in Southern and Eastern Asia is real (caused by genetic or environmental factors) or spurious (because of differences in awareness of the condition among physicians or different interpretations of endoscopic and histologic features). We aimed to estimate the prevalence of IBD in patients of different ethnicities who underwent endoscopy in the United States, with ileocolonic biopsies evaluated by a single group of gastrointestinal pathologists.
  
  
  METHODS
  We used a national pathology database to collect data on 1,027,977 subjects who underwent colonoscopy with ileocolonic biopsies from January 2008 through December 2013 throughout the United States; mucosal biopsy specimens were evaluated and reported by 1 group of 35 histopathologists. Patients were stratified into the following ancestries: Indian (persons with ancestry in the Indian subcontinent), East Asian (China, Korea, Japan, and Vietnam), Hispanic, Jewish, and Other. The prevalence of ulcerative colitis (UC), Crohn's disease (CD), and indeterminate colitis was determined for each ethnic group.
  
  
  RESULTS
  In the study population, 30,812 patients were diagnosed with IBD (20,308 with UC, 7706 with CD, and 2798 with indeterminate colitis). UC was more commonly associated with Indian and Jewish ethnicity and less commonly associated with East Asian and Hispanic ethnicity. Similar patterns also applied to CD and to all types of IBD analyzed jointly. Among Indian patients, 11.7% of those of Gujarati origins had IBD, compared with 7.9% of other Indians (odds ratio, 1.5; 95% confidence interval, 1.14-2.11).
  
  
  CONCLUSIONS
  Patients of Indian origin living in the United States have a greater risk for all types of IBD than other American populations. East Asians and Hispanics have a lower risk, possibly similar to that of the populations still living in their original countries. These findings may have relevance to the practice of gastroenterology in countries where there are sizable portions of the population with roots in the Indian subcontinent.
authors.affiliation: Miraca Life Sciences Research Institute, Irving, Texas.
authors.forename: Reenu
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Miraca Life Sciences Research Institute, Irving, Texas.
authors.forename: Kevin
authors.initials: K
authors.lastname: Turner
authors.affiliation: Portland VA Medical Center, Portland, Oregon; Oregon Health and Science University, Portland, Oregon.
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
authors.affiliation: Miraca Life Sciences Research Institute, Irving, Texas; University of Texas Southwestern Medical Center and Dallas VA Medical Center, Dallas, Texas. Electronic address: robert.genta@utsouthwestern.edu.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003113:Colonoscopy; D005006:Ethnicity; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Ethnic Studies; Indian Immigrants; Latino; Lifestyle; Western