title: Clinical Expression of Multiple Sclerosis in Hispanic Whites of Primarily Caribbean Ancestry.
abstract: OBJECTIVE
  The clinical characteristics of multiple sclerosis (MS) are not well defined in Hispanic populations. We hypothesized that disease presentation in Hispanic white (HW) patients will be different from non-Hispanic white (NHW) patients given their ancestral background and reported lower disease prevalence. This study was undertaken to compare HW of primarily Caribbean ancestry to NHW on clinical characteristics of MS.
  
  
  METHODS
  We assessed 312 HW and 312 NHW patients with definite MS for clinical disease characteristics obtained through consented review of medical records. In order to assess the relationship between age-related phenotypes and ethnicity, linear regression was used. Logistic regression was used to assess the relationship between ethnicity and descriptors of disease presentation and severity as well as presence of neurological symptoms.
  
  
  RESULTS
  We observed a significantly younger age at diagnosis (p = 1.38E-02) and age at exam (p = 2.36E-05) in HW. However, age at first symptom did not differ significantly between the two groups. Furthermore, within HW, the mean age at first symptom and age at diagnosis was significantly younger in those born in the United States (p < 1.00E-03 for both). Interestingly, we noted an increase in ambulatory disability in HW patients, primarily among those with relapsing disease (p = 4.18E-03).
  
  
  CONCLUSIONS
  We found several differences in age-related phenotypes and disease severity between HW of primarily Caribbean origin and NHW patients. To our knowledge, this is the largest study to date that examined the clinical characteristics of MS in Hispanic patients of largely Caribbean origin.
authors.affiliation: John P. Hussman Institute for Human Genomics, University of Miami, Miami, Fla., USA.
authors.forename: Athena
authors.initials: A
authors.lastname: Hadjixenofontos
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Beecham
authors.forename: Clara P
authors.initials: CP
authors.lastname: Manrique
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Pericak-Vance
authors.forename: Leticia
authors.initials: L
authors.lastname: Tornes
authors.forename: Melissa
authors.initials: M
authors.lastname: Ortega
authors.forename: Kottil W
authors.initials: KW
authors.lastname: Rammohan
authors.forename: Jacob L
authors.initials: JL
authors.lastname: McCauley
authors.forename: Sylvia R
authors.initials: SR
authors.lastname: Delgado
mesh_terms: D000328:Adult; D000367:Age Factors; D017691:Caribbean Region; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000208:ethnology*; D010641:Phenotype; D044465:White People