Rabiee Atoosa, Polanco Nathalie A Pena, Vara Aymara Fernandez De La, Levy Cynthia
Department of Gastroenterology and Hepatology, VA Medical Center, Washington DC, USA.
Divison of Digestive Health and Liver Diseases Department of Medicine University of Miami Miller School of Medicine USA.
J Clin Transl Hepatol. 2020 Dec 28;8(4):391-396. doi: 10.14218/JCTH.2020.00006. Epub 2020 Oct 29.
Hispanic patients with primary biliary cholangitis (PBC) have reduced rates of biochemical response to ursodeoxycholic acid (UDCA) and increased risk of disease progression compared to non-Hispanic patients. In this study, we sought to identify differences in demographics, comorbidities, environmental risk factors and socioeconomic status between Hispanic and non-Hispanic patients with PBC. In a case control study, we analyzed data from Hispanic (=37 females and 1 male) and non-Hispanic (=54 females and 4 males) patients with PBC seen at the University of Miami/Jackson Memorial Hospital from January 1998 through January 2013. Data were obtained by filling out a questionnaire either via phone call, mail, or e-mail. Odds ratios were calculated to measure the association between exposure and outcomes. Baseline demographics, environmental risk factors and comorbidities were similar between Hispanic and non-Hispanic patients with PBC. Hispanic patients were less likely to be married and fewer Hispanics had education beyond high school level compared to non-Hispanics. Sixty four percent of Hispanic patients had a household income of less than $50000, compared to 19.5% of non-Hispanics. Fewer Hispanic patients with PBC had health insurance coverage compared to non-Hispanics (86.5% vs. 98.1%; odds ratio: 0.1, 95% confidence interval: 0-0.9). Differences in disease severity and response to therapy observed in prior studies could not be explained by environmental exposures. In addition to genetic variation, socioeconomic discrepancies (access to care) may further explain these differences.
与非西班牙裔患者相比，患有原发性胆汁性胆管炎（PBC）的西班牙裔患者对熊去氧胆酸（UDCA）的生化反应率较低，且疾病进展风险增加。在本研究中，我们试图确定患有PBC的西班牙裔和非西班牙裔患者在人口统计学、合并症、环境风险因素和社会经济地位方面的差异。在一项病例对照研究中，我们分析了1998年1月至2013年1月在迈阿密大学/杰克逊纪念医院就诊的患有PBC的西班牙裔患者（37名女性和1名男性）和非西班牙裔患者（54名女性和4名男性）的数据。数据通过电话、邮件或电子邮件填写问卷获得。计算比值比以衡量暴露与结果之间的关联。患有PBC的西班牙裔和非西班牙裔患者在基线人口统计学、环境风险因素和合并症方面相似。与非西班牙裔患者相比，西班牙裔患者结婚的可能性较小，接受高中以上教育的人数也较少。64%的西班牙裔患者家庭收入低于50000美元，而非西班牙裔患者这一比例为19.5%。与非西班牙裔患者相比，患有PBC的西班牙裔患者获得医疗保险的比例较低（86.5%对98.1%；比值比：0.1，95%置信区间：0 - 0.9）。先前研究中观察到的疾病严重程度和治疗反应的差异无法用环境暴露来解释。除了基因变异外，社会经济差异（获得医疗服务的机会）可能进一步解释这些差异。
