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Meta-Analysis
. 2018 Feb;16(2):190-197.e11.
doi: 10.1016/j.cgh.2017.05.047. Epub 2017 Jun 8.

Ethnicity Influences Phenotype and Outcomes in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis of Population-based Studies

Hai Yun Shi  1 , Alexander N Levy  2 , Hirsh D Trivedi  2 , Francis K L Chan  3 , Siew C Ng  4 , Ashwin N Ananthakrishnan  5
Affiliations
Meta-Analysis

Ethnicity Influences Phenotype and Outcomes in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis of Population-based Studies

Hai Yun Shi et al. Clin Gastroenterol Hepatol. 2018 Feb.

Abstract

Background & aims: Inflammatory bowel diseases (IBDs) (Crohn's disease [CD], ulcerative colitis) are global diseases. Similarities and differences in disease presentation and outcomes across different geographic regions and ethnic groups have not been compared previously.

Methods: We performed a systematic review and meta-analysis of population-based cohort studies examining the phenotype and outcome of IBD across ethnic groups categorized as Whites, Blacks, Hispanics, and Asians. Further stratification was performed by migration status (native or immigrant). Pooled proportions of disease location, behavior, medication, and surgery use were calculated by using a random-effects model and compared statistically.

Results: Our final analysis included 198 unique studies reporting outcomes on 525,425 IBD patients (Caucasian, 65%; Asian, 30%; Hispanic, 2%; and Black, 1%). CD in Asians but not other ethnicities demonstrated a strong male predominance. Family history of IBD was infrequent in Asian patients. Both Black and Asian CD patients demonstrated perianal involvement more frequently. Surgery for both CD and UC was less common in Asians than Caucasians. Compared with native residents, a family history of IBD was reported more often among immigrant IBD patients, but no significant differences were noted in phenotype.

Conclusions: We demonstrate significant variation in the demographic distribution, familial predisposition, phenotype, and outcomes of IBD between Caucasians, Blacks, Hispanics, and Asians. There is need for further study to understand the biology behind this variation.

Keywords: Behavior; Crohn’s Disease; Ethnicity; Race; Surgery; Ulcerative Colitis.

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Conflict of interest statement

Conflicts of Interest and Disclosures: Other authors have no conflicts to disclose.

Figures

Figure 1
Figure 1
Prevalence of perianal Crohn’s disease, by ethnicity
Figure 2
Figure 2
Rate of surgery 1 and 5 years after diagnosis among patients with Crohn’s disease, by ethnicity (a) 1 year (b) 5 years
Figure 3
Figure 3
Rate of surgery 1 and 5 years after diagnosis among patients with Ulcerative colitis, by ethnicity (a) 1 year (b) 5 years
See this image and copyright information in PMC

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