Khalessi Ali, Crowe Brooks R, Xia Yuhe, Rubinfeld Gregory, Baylor Jessica, Radin Arielle, Liang Peter S, Chen Lea Ann
Department of Medicine, New York University School of Medicine, New York, New York.
Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, New York.
Gastro Hep Adv. 2024;3(3):326-332. doi: 10.1016/j.gastha.2023.11.021. Epub 2023 Dec 16.
The prevalence of inflammatory bowel disease (IBD) is increasing globally. In this context, identifying risk factors for severe disease is important. We examined how race/ethnicity and immigration status influence IBD manifestations, treatments, and outcomes in a diverse, tertiary-care safety-net hospital.
We conducted a single-center retrospective review of all IBD inpatients and outpatients treated from 1997-2017. Using logistic regression modeling, we compared disease onset, treatment, and outcomes by race (White, Black, Hispanic, or Asian) and immigration status (US-born vs foreign-born).
A total of 577 patients were identified, of which 29.8% were White, 27.4% were Hispanic, 21.7% were Black, and 13.0% were Asian. Compared to Whites, Asians were more likely to be male (odds ratio [OR] 2.63, 95% confidence interval [CI]: 1.45, 5.00), whereas Blacks were more likely to be diagnosed with Crohn's disease (OR 1.75, 95% CI: 1.10, 2.77) and more likely to undergo IBD-related intestinal resection (OR 2.49, 95% CI: 1.40, 4.50). Compared to US-born patients, foreign-born patients were more likely to be diagnosed with ulcerative colitis (OR 1.77, 95% CI: 1.04, 3.02). They were also less likely to be diagnosed before 16 years of age (OR 0.19, 95% CI: 0.08, 0.41), to have undergone intestinal resections (OR 0.39, 95% CI: 0.19, 0.83), to have received biologics (OR 0.43, 95% CI: 0.25, 0.76), or to have had dermatologic manifestations (OR 0.12, 95% CI: 0.03, 0.41).
IBD phenotype varies by race, although foreign-born patients of all races show evidence of later-onset and milder disease. These findings may aid in disease prognostication and clinical management and, furthermore, may provide insight into intrinsic and environmental influences on IBD pathogenesis.
炎症性肠病（IBD）在全球的患病率正在上升。在此背景下，识别严重疾病的风险因素很重要。我们研究了种族/族裔和移民身份如何影响一家多元化的三级医疗安全网医院中IBD的表现、治疗及预后。
我们对1997年至2017年期间治疗的所有IBD住院患者和门诊患者进行了单中心回顾性研究。使用逻辑回归模型，我们按种族（白人、黑人、西班牙裔或亚裔）和移民身份（美国出生与外国出生）比较了疾病发病情况、治疗及预后。
共识别出577例患者，其中29.8%为白人，27.4%为西班牙裔，21.7%为黑人，13.0%为亚裔。与白人相比，亚裔男性比例更高（优势比[OR]2.63，95%置信区间[CI]：1.45，5.00），而黑人更易被诊断为克罗恩病（OR 1.75，95% CI：1.10，2.77），且更有可能接受与IBD相关的肠道切除术（OR 2.49，95% CI：1.40，4.50）。与美国出生的患者相比，外国出生的患者更易被诊断为溃疡性结肠炎（OR 1.77，95% CI：1.04，3.02）。他们在16岁之前被诊断的可能性也较小（OR 0.19，95% CI：0.08，0.41），接受肠道切除术的可能性较小（OR 0.39，95% CI：0.19，0.83），接受生物制剂治疗的可能性较小（OR 0.43，95% CI：0.25，0.76），出现皮肤表现的可能性较小（OR 0.12，95% CI：0.03，0.41）。
IBD的表型因种族而异，尽管所有种族的外国出生患者都表现出发病较晚且病情较轻的迹象。这些发现可能有助于疾病的预后评估和临床管理，此外，还可能为IBD发病机制的内在和环境影响提供见解。
