- Fecal Incontinence
|Hispanic Americans and Non-Hispanic White Americans Have a Similar Inflammatory Bowel Disease Phenotype: A Systematic Review with Meta-Analysis
Avalos DJ1, Mendoza-Ladd A2, Zuckerman MJ2, Bashashati M2, Alvarado A3, Dwivedi A3, Damas OM4. Dig Dis Sci. 2018 Mar 29. doi: 10.1007/s10620-018-5022-7. [Epub ahead of print]
1 Division of Gastroenterology, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Ave., El Paso, TX, 79905, USA. Danny.email@example.com.
2 Division of Gastroenterology, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Ave., El Paso, TX, 79905, USA.
3 Department of Biostatistics, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.
4 Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, FL, USA.
BACKGROUND: Inflammatory bowel disease (IBD) is a devastating immune-mediated disease on the rise in Hispanics living in the USA. Prior observational studies comparing IBD characteristics between Hispanics and non-Hispanic whites (NHW) have yielded mixed results.
AIMS: We performed a meta-analysis of observational studies examining IBD phenotype in Hispanics compared to NHW.
METHODS: We conducted a systematic search of US-based studies comparing IBD subtype (Ulcerative Colitis: UC or Crohn's disease: CD) and phenotype (disease location and behavior) between Hispanics and NHW. We evaluated differences in age at IBD diagnosis, the presence of family history and smoking history. A random effects model was chosen "a priori." Categorical and continuous variables were analyzed using odds ratio (OR) or standard mean difference (SMD), respectively.
RESULTS: Seven studies were included with 687 Hispanics and 1586 NHW. UC was more common in Hispanics compared to NHW (OR 2.07, CI 1.13-3.79, p = 0.02). Location of disease was similar between Hispanics and NHW except for the presence of upper gastrointestinal CD, which was less common in Hispanics (OR 0.58, CI 0.32-1.06, p = 0.07). Hispanics were less likely to smoke (OR 0.48, CI 0.26-0.89, p = 0.02) or have a family history of IBD (OR 0.35, CI 0.22-0.55, p < 0.001). CD behavior classified by Montreal classification and age at IBD diagnosis were similar between Hispanics and NHW.
CONCLUSION: UC was more common among US Hispanics compared to NHW. Age at IBD diagnosis is similar for both Hispanics and NHW. For CD, disease behavior is similar, but Hispanics show a trend for less upper gastrointestinal involvement. A family history of IBD and smoking history were less common in Hispanics.