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美国胃肠道症状及诊断方面的种族差异与感染风险的关联

Ethnic/racial differences in gastrointestinal symptoms and diagnosis associated with the risk of infection in the US.

作者信息

Huerta-Franco Maria-Raquel, Banderas Julie W, Allsworth Jenifer E

机构信息

Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.

Department of Applied Sciences to Work, Division of Health Sciences, Campus Leon, University of Guanajuato, Leon, Mexico.

出版信息

Clin Exp Gastroenterol. 2018 Jan 18;11:39-49. doi: 10.2147/CEG.S144967. eCollection 2018.

Abstract

BACKGROUND

In the US, neither the prevalence nor the gastrointestinal (GI) diagnosis/symptoms associated with (HP) have been examined in different racial/ethnic groups.

AIM

To determine the racial/ethnic differences in HP infection associated with GI diagnoses/symptoms using the Cerner Health Facts database.

METHODS

This cross-sectional study collected data during the period of 2000-2015 from the following ethnic/racial groups: 8,236,317 white, 2,085,389 black, 426,622 Hispanic, 293,156 Asian Pacific/Islander (APIs), and 89,179 Native American/Alaskan Native (NA/AN) patients aged 21-65 years old; the data were then analyzed. The primary dependent variable was a diagnosis of HP (ICD-9-Clinical Modification/ICD-10 classification). SAS version 9.4 was used for the statistical analysis. The statistical analysis was performed on 11,130,663 patients with GI symptoms, and of these, 152,086 patients were positive for the infection.

RESULTS

Hispanics and NA/ANs had the highest prevalence of HP associated with upper GI symptoms/diagnosis. Nevertheless, blacks and APIs presented the highest relative risk (RR) of HP associated with dyspepsia (RR [95% CI] =11.2 [10.7-11.9] and 14.2 [12.8-15.6]), peptic ulcer (RR =13.8 [13.3-14.5] and 10.7 [9.3-12.3]), and atrophic gastritis (RR =9 [8.5-9.6] and 7.4 [6.4-8.5]), respectively. In all racial/ethnic groups, HP was also associated with inflammatory bowel diseases, liver diseases, and celiac diseases.

CONCLUSION

Black and API populations had the highest risk of HP associated with upper GI symptoms/diagnosis. Black patients also had the highest risk for HP associated with GI cancer.

摘要

背景

在美国,尚未对不同种族/族裔群体中幽门螺杆菌(HP)的患病率以及与之相关的胃肠道(GI)诊断/症状进行研究。

目的

利用Cerner健康事实数据库确定与GI诊断/症状相关的HP感染的种族/族裔差异。

方法

这项横断面研究在2000年至2015年期间收集了以下种族/族裔群体的数据:8236317名白人、2085389名黑人、426622名西班牙裔、293156名亚太/岛民(API)以及89179名21至65岁的美国原住民/阿拉斯加原住民(NA/AN)患者;然后对数据进行分析。主要因变量是HP诊断(国际疾病分类第九版临床修订本/国际疾病分类第十版分类)。使用SAS 9.4版进行统计分析。对11130663名有GI症状的患者进行了统计分析,其中152086名患者感染呈阳性。

结果

西班牙裔和美国原住民/阿拉斯加原住民中与上消化道症状/诊断相关的HP患病率最高。然而,黑人和亚太/岛民中与消化不良(相对风险[RR][95%置信区间]=11.2[10.7 - 11.9]和14.2[12.8 - 15.6])、消化性溃疡(RR = 13.8[13.3 - 14.5]和10.7[9.3 - 12.3])以及萎缩性胃炎(RR = 9[8.5 - 9.6]和7.4[6.4 - 8.5])相关的HP相对风险最高。在所有种族/族裔群体中,HP还与炎症性肠病、肝病和乳糜泻有关。

结论

黑人和亚太/岛民群体中与上消化道症状/诊断相关的HP风险最高。黑人患者中与GI癌症相关的HP风险也最高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acd0/5779296/623b7e8fed70/ceg-11-039Fig1.jpg

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