title: The influence of Helicobacter pylori on the ethnic distribution of esophageal eosinophilia.
abstract: BACKGROUND
  Environmental factors associated with ethnicity may contribute to the occurrence of eosinophilic esophagitis. Our study aimed to investigate the influence of Helicobacter pylori on the ethnic variation of esophageal eosinophilia in a large national sample of patients undergoing esophago-gastro-duodenoscopy.
  
  
  METHODS
  The Miraca Life Sciences Database is an electronic repository of histopathologic patient records. A case-control study evaluated the influence of ethnicity on the occurrence of esophageal eosinophilia and how age, gender, and histologic diagnosis of H. pylori modify this relationship.
  
  
  RESULTS
  The total study population comprised 596 479 subjects, of whom 25 969 harbored a diagnosis of esophageal eosinophilia. Young age, male sex, and H. pylori infection in declining order exerted the strongest influence on the occurrence of esophageal eosinophilia. In comparison with the population comprising of Caucasians and African-Americans, esophageal eosinophilia was less common among patients of African (OR=0.10, 95% CI=0.01-0.46), Middle Eastern (0.22, 0.15-0.31), East Asian (0.32, 0.26-0.38), Indian (0.28, 0.21-0.37), Hispanic (0.40, 0.37-0.43), or Jewish descent (0.58, 0.51-0.66), but more common among patients of Northern European descent (1.25, 1.07-1.45). With the exception of Northern Europeans, all ethnic subgroups were characterized by a higher prevalence of H. pylori than the comparison group. A low prevalence of H. pylori was significantly associated with a high prevalence of esophageal eosinophilia (R2=0.90, P<.001).
  
  
  CONCLUSIONS
  Esophageal eosinophilia prevalence markedly varies by patient ethnicity. As there is a strong inverse correlation between H. pylori and esophageal eosinophilia, H. pylori infection may be in part responsible for the observed ethnic distribution of esophageal eosinophilia.
authors.affiliation: Division of Gastroenterology and Hepatology, Portland VA Medical Center, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
authors.affiliation: Division of Gastroenterology and Hepatology, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, NC, USA.|Division of Gastroenterology and Hepatology, Center for Gastrointestinal Biology and Disease, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.affiliation: Miraca Life Sciences, Irving, TX, USA.|Baylor College of Medicine, Houston, TX, USA.
authors.forename: Kevin O
authors.initials: KO
authors.lastname: Turner
authors.affiliation: Miraca Life Sciences, Irving, TX, USA.|Baylor College of Medicine, Houston, TX, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult
keywords: 
  Helicobacter pylori
  ; environmental risk factors; eosinophilic esophagitis; epidemiology; ethnicity