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

Dig Dis Sci. 2018 Jun;63(6):1558-1571. doi: 10.1007/s10620-018-5022-7. Epub 2018 Mar 29.

Abstract

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.

Keywords: Hispanic Americans; Inflammatory bowel diseases; Minority groups; Phenotype.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / ethnology*
  • Colitis, Ulcerative / genetics
  • Crohn Disease / diagnosis
  • Crohn Disease / ethnology*
  • Crohn Disease / genetics
  • Genetic Predisposition to Disease
  • Hispanic or Latino*
  • Humans
  • Observational Studies as Topic
  • Odds Ratio
  • Pedigree
  • Phenotype
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / ethnology
  • United States / epidemiology
  • White People*