Original Contribution

The American Journal of Gastroenterology (2006) 101, 1012–1023; doi:10.1111/j.1572-0241.2006.00504.x

Inflammatory Bowel Disease Characteristics Among African Americans, Hispanics, and Non-Hispanic Whites: Characterization of a Large North American Cohort

Geoffrey C Nguyen MD1, Esther A Torres MD2, Miguel Regueiro MD3, Gillian Bromfield MSc4, Alain Bitton MD, FRCP(C)5, Joanne Stempak6, Themistocles Dassopoulos MD1, Philip Schumm4, Federico J Gregory MD2, Anne M Griffiths MD7, Stephen B Hanauer MD4, Jennifer Hanson3, Mary L Harris MD1, Sunanda V Kane MD, MSPH4, Heather Kiraly Orkwis3, Raymond Lahaie MD8, Maria Oliva-Hemker MD9, Pierre Pare MD, FRCP(C), FACG10, Gary E Wild MD, PhD, FRCP(C)11, John D Rioux PhD12,13, Huiying Yang MD, PhD14, Richard H Duerr MD3,15, Judy H Cho MD4, A Hillary Steinhart MD6, Steven R Brant MD1,16 and Mark S Silverberg MD, PhD6

  1. 1Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
  2. 2Department of Medicine, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico
  3. 3Inflammatory Bowel Disease Center and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  4. 4The University of Chicago, Chicago, Illinois
  5. 5Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada
  6. 6Department of Medicine, Mount Sinai Hospital Inflammatory Bowel Disease Centre, University of Toronto, Toronto, Canada
  7. 7Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada
  8. 8Hôpital St. Luc, Centre Hospitalier, Université de Montréal, Quebec, Canada
  9. 9Pediatric Gastroenterology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
  10. 10Hôpital du Saint-Sacrement, Quebec, Canada
  11. 11Montreal General Hospital, McGill University, Quebec, Canada
  12. 12The Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
  13. 13The Montréal Heart Institute and the Université de Montréal, Quebec, Canada
  14. 14Division of Medical Genetics and Inflammatory Bowel Disease Center, Cedar-Sinai Medical Center, Los Angeles, California
  15. 15Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
  16. 16Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

Correspondence: Steven R Brant, MD, 1503 E. Jefferson Street, Rm. B-136, Baltimore, MD 21205.

Received 9 September 2005; Accepted 11 November 2005.

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Abstract

OBJECTIVES:

 

Inflammatory bowel disease (IBD), comprising primarily of Crohn's disease (CD) and ulcerative colitis (UC), is increasingly prevalent in racial and ethnic minorities. This study was undertaken to characterize racial differences in disease phenotype in a predominantly adult population.

METHODS:

 

Phenotype data on 830 non-Hispanic white, 127 non-Hispanic African American, and 169 Hispanic IBD patients, recruited from six academic centers, were abstracted from medical records and compiled in the NIDDK-IBD Genetics Consortium repository. We characterized racial differences in family history, disease location and behavior, surgical history, and extraintestinal manifestations (EIMs) using standardized definitions.

RESULTS:

 

African American CD patients were more likely than whites to develop esophagogastroduodenal CD (OR = 2.8; 95% CI: 1.4–5.5), colorectal disease (OR = 1.9; 95% CI: 1.1–3.4), perianal disease (OR = 1.7; 95% CI: 1.03–2.8), but less likely to have ileal involvement (OR = 0.55; 95% CI: 0.32–0.96). They were also at higher risk for uveitis (OR = 5.5; 95% CI: 2.3–13.0) and sacroiliitis (OR = 4.0; 95% CI: 1.55–10.1). Hispanics had higher prevalence of perianal CD (OR = 2.9; 95% CI: 1.8–4.6) and erythema nodosum (3.3; 95% CI: 1.7–6.4). Among UC patients, Hispanics had more proximal disease extent. Both African American and Hispanic CD patients, but not UC patients, had lower prevalences of family history of IBD than their white counterparts.

CONCLUSIONS:

 

There are racial differences in IBD family history, disease location, and EIMs that may reflect underlying genetic variations and have important implications for diagnosis and management of disease. These findings underscore the need for further studies in minority populations.

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