Hispanic Americans and Non-Hispanic White Americans Have a Similar Inflammatory Bowel Disease Phenotype: A Systematic Review with Meta-Analysis

• Published in: Digestive diseases and sciences Vol. 63; no. 6; pp. 1558 - 1571
• Main Authors: Avalos, Danny J., Mendoza-Ladd, Antonio, Zuckerman, Marc J., Bashashati, Mohammad, Alvarado, Andres, Dwivedi, Alok, Damas, Oriana M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2018; Springer; Springer Nature B.V
• Subjects: Biochemistry; Comparative analysis; Gastroenterology; Genetic aspects; Genotype & phenotype; Hepatology; Hispanic people; Inflammatory bowel disease; Medicine; Medicine & Public Health; Meta-analysis; Oncology; Original Article; Systematic review; Transplant Surgery; Ulcerative colitis; White people; United States > US; Inflammatory bowel diseases; Phenotype; Minority groups; Hispanic Americans
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-018-5022-7

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.