Sonnenberg Amnon, Turner Kevin O, Genta Robert M
Miraca Life Sciences, Irving, TX, USA.
Portland VA Medical Center, Oregon Health and Science University, P3-GI, Portland, OR, 97239, USA.
Dig Dis Sci. 2017 Apr;62(4):1009-1015. doi: 10.1007/s10620-016-4441-6. Epub 2017 Jan 9.
Previous studies found that microscopic colitis is inversely associated with Helicobacter pylori infection and that microscopic colitis is characterized by a marked ethnic variation.
The aim of the present study was to test whether an underlying ethnic variation of H. pylori infection is responsible for the ethnic variation of microscopic colitis.
The Miraca Life Sciences Database is a large national electronic repository of histopathologic records of patients distributed throughout the entire USA. A cross-sectional study evaluated the influence of age, gender, ethnicity, and histologic diagnosis of H. pylori on the occurrence of microscopic colitis among subjects who underwent esophago-gastro-duodenoscopies plus colonoscopy.
The total study population comprised 228,506 subjects, of whom 28,890 carried a diagnosis of H. pylori gastritis and 3460 microscopic colitis. Female sex, old age, and H. pylori infection exerted the strongest influence on the occurrence of microscopic colitis. In comparison with the population comprising Caucasians and African-Americans, microscopic colitis was less common among subjects of Hispanic (0.34, 0.27-0.47), East Asian (0.13, 0.06-0.22), Indian (0.31, 0.10-0.73), or Middle Eastern descent (0.28, 0.07-0.74). All these ethnic subgroups were also characterized by a higher prevalence of H. pylori than the comparison group. A low prevalence of H. pylori was significantly associated with a high prevalence of microscopic colitis (R = 0.91, p < 0.001).
Ethnic variations in the gastric infection with H. pylori may be partly responsible for the observed ethnic distribution of microscopic colitis.
既往研究发现，显微镜下结肠炎与幽门螺杆菌感染呈负相关，且显微镜下结肠炎具有显著的种族差异。
本研究旨在检验幽门螺杆菌感染潜在的种族差异是否是显微镜下结肠炎种族差异的原因。
Miraca生命科学数据库是一个大型的全国性电子数据库，收录了分布于美国各地患者的组织病理学记录。一项横断面研究评估了年龄、性别、种族以及幽门螺杆菌的组织学诊断对接受食管-胃-十二指肠镜检查加结肠镜检查的受试者发生显微镜下结肠炎的影响。
总研究人群包括228,506名受试者，其中28,890名被诊断为幽门螺杆菌胃炎，3460名患有显微镜下结肠炎。女性、老年和幽门螺杆菌感染对显微镜下结肠炎的发生影响最大。与白人和非裔美国人组成的人群相比，显微镜下结肠炎在西班牙裔（0.34，0.27 - 0.47）、东亚裔（0.13，0.06 - 0.22）、印度裔（0.31，0.10 - 0.73）或中东裔（0.28，0.07 - 0.74）受试者中较少见。所有这些种族亚组的幽门螺杆菌患病率也高于对照组。幽门螺杆菌低患病率与显微镜下结肠炎高患病率显著相关（R = 0.91，p < 0.001）。
幽门螺杆菌胃部感染的种族差异可能部分导致了观察到的显微镜下结肠炎的种族分布情况。
