Department of Pediatrics, Baylor College of Medicine, Houston, TX77030, USA.
Inflamm Bowel Dis. 2012 Mar;18(3):546-54. doi: 10.1002/ibd.21698. Epub 2011 Mar 31.
Inflammatory bowel disease (IBD) has a wide spectrum and variability among different ethnic groups. We aimed to evaluate disease characteristics in the pediatric Hispanic population, which has not been well studied.
We identified patients <18 years old seen at Texas Children's Hospital (TCH) and diagnosed with IBD between 2004 and 2009. We compared them with their White, African American, and "other" counterparts with regard to their demographics, disease characteristics, and initial therapy.
There were a total of 399 patients with IBD: 211 (52.9%) White, 67 (16.8%) African American, 53 (13.3%) Hispanic, and 68 (17%) "other." Crohn's disease (CD) was the most common IBD type among all groups; however, Hispanics had the highest proportion of patients with ulcerative colitis (UC) and IBD-unclassified (IBD-U). There was male predominance in all groups except African Americans. Hispanics had the highest percentage of Medicaid coverage (P < 0.01) and none of the Hispanics had a first-degree relative with IBD. They had a younger age at diagnosis but a similar duration of symptoms prior to diagnosis. Hispanics had less failure to thrive and a higher body mass index (BMI) Z-score. Hispanics with CD more often received systemic steroids while those with UC and IBD-U were more often treated with local steroids (P < 0.01), oral 5-aminosalicylate (P < 0.01), and less often received immunomodulators or biologics (P = 0.05).
We demonstrate differences in disease characteristics between Hispanics and other ethnicities with IBD. Further epidemiologic studies are needed, including longer-term follow-up, to better define the burden of illness in Hispanics.
炎症性肠病(IBD)在不同种族群体之间具有广泛的谱和变异性。我们旨在评估西班牙裔儿科人群中的疾病特征,而这方面的研究还不够充分。
我们确定了 2004 年至 2009 年间在德克萨斯儿童健康医院(TCH)就诊并被诊断为 IBD 的年龄<18 岁的患者。我们将他们与白种人、非裔美国人和“其他”人群进行了比较,比较了他们的人口统计学特征、疾病特征和初始治疗。
共有 399 例 IBD 患者:211 例(52.9%)为白种人,67 例(16.8%)为非裔美国人,53 例(13.3%)为西班牙裔,68 例(17%)为“其他”。所有人群中最常见的 IBD 类型是克罗恩病(CD);然而,西班牙裔人群中溃疡性结肠炎(UC)和 IBD 未分类(IBD-U)患者的比例最高。除非裔美国人外,所有人群均以男性为主。西班牙裔人群中医疗补助计划(Medicaid)的覆盖率最高(P<0.01),且没有一个西班牙裔患者有一级亲属患有 IBD。他们的诊断年龄最小,但诊断前的症状持续时间相似。西班牙裔患者体重不足的比例较低,体重指数(BMI)Z 评分较高。患有 CD 的西班牙裔患者更常接受全身类固醇治疗,而患有 UC 和 IBD-U 的患者更常接受局部类固醇治疗(P<0.01)、口服 5-氨基水杨酸(P<0.01)治疗,较少接受免疫调节剂或生物制剂治疗(P=0.05)。
我们证明了西班牙裔与其他 IBD 患者在疾病特征方面存在差异。需要进一步开展流行病学研究,包括进行长期随访,以更好地确定西班牙裔人群的疾病负担。