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African-American inflammatory bowel disease in a Southern U.S. health center.

Veluswamy H, Suryawala K, Sheth A, Wells S, Salvatierra E, Cromer W, Chaitanya GV, Painter A, Patel M, Manas K, Zwank E, Boktor M, Baig K, Datti B, Mathis MJ, Minagar A, Jordan PA, Alexander JS - BMC Gastroenterol (2010)

Bottom Line: Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0).Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios.Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dept of Molecular & Cellular Physiology, 1501 Kings Highway, Shreveport, LA, 71130-3932, USA.

ABSTRACT

Background: Inflammatory Bowel Diseases (IBD) remain significant health problems in the US and worldwide. IBD is most often associated with eastern European ancestry, and is less frequently reported in other populations of African origin e.g. African Americans ('AAs'). Whether AAs represent an important population with IBD in the US remains unclear since few studies have investigated IBD in communities with a majority representation of AA patients. The Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) is a tertiary care medical center, with a patient base composed of 58% AA and 39% Caucasian (W), ideal for evaluating racial (AA vs. W) as well and gender (M vs. F) influences on IBD.

Methods: In this retrospective study, we evaluated 951 visits to LSUHSC-S for IBD (between 2000 to 2008) using non-identified patient information based on ICD-9 medical record coding (Crohn's disease 'CD'-555.0- 555.9 and ulcerative colitis 'UC'-556.0-556.9).

Results: Overall, there were more cases of CD seen than UC. UC and CD affected similar ratios of AA and Caucasian males (M) and females (F) with a rank order of WF > WM > AAF > AAM. Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0). Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios.

Conclusion: Although Caucasians still represent the greatest fraction of IBD (~64%), AAs with IBD made up >1/3 (36.4%) of annual IBD cases from 2000-2008 at LSUHSC-S. Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.

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Annual CD and UC cases by gender/racial group. In fig. 2A the average number of cases seen annually for Crohn's disease is greater amongst Caucasian females than AA females (**, p < 0.01), and is also greater amongst Caucasian M when compared to AA M (***, p < 0.001). In fig. 2B the average number of cases seen annually for UC is greater amongst Caucasian females than Caucasian M (*, p < 0.05), Caucasian females than AA females (**, p < 0.01), and Caucasian M than AA M (*, p < 0.05). * Significantly different with p < 0.05; ** significantly different with p < 0.01; *** significantly different with p < 0.001 using one-way ANOVA, Tukey-Kramer multiple comparison.
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Figure 2: Annual CD and UC cases by gender/racial group. In fig. 2A the average number of cases seen annually for Crohn's disease is greater amongst Caucasian females than AA females (**, p < 0.01), and is also greater amongst Caucasian M when compared to AA M (***, p < 0.001). In fig. 2B the average number of cases seen annually for UC is greater amongst Caucasian females than Caucasian M (*, p < 0.05), Caucasian females than AA females (**, p < 0.01), and Caucasian M than AA M (*, p < 0.05). * Significantly different with p < 0.05; ** significantly different with p < 0.01; *** significantly different with p < 0.001 using one-way ANOVA, Tukey-Kramer multiple comparison.

Mentions: The annual number of cases per race/gender group was also compared for each condition. In both CD and UC, the average annual number of cases was highest amongst Caucasian F followed by Caucasian M followed by AA F, and finally the lowest number of cases was seen amongst AA M. When comparing this data in CD, Caucasian females had significantly more cases per year than AA females (**, p < 0.01). This was also seen when comparing Caucasian M to AAM (***, p < 0.001) (Fig. 2A). In UC, Caucasian F had significantly more cases per year than Caucasian M (*, p < 0.05) and AA F (**, p < 0.01). When comparing Caucasian M to AA M with UC, Caucasian M had more cases per year (*, p < 0.05) (Fig. 2B). Using the above-mentioned data, the average annual visits per person were calculated by taking the total number of visits per group yearly and dividing that number by the number of cases per respective group. Amongst Crohn's disease patients, AA M made more visits annually to LSUHSC-Shreveport than Caucasian M with this disease (*, p < 0.05) (Fig. 3). Further analysis for the trend of this disease was studied over 9 years for each group.


African-American inflammatory bowel disease in a Southern U.S. health center.

Veluswamy H, Suryawala K, Sheth A, Wells S, Salvatierra E, Cromer W, Chaitanya GV, Painter A, Patel M, Manas K, Zwank E, Boktor M, Baig K, Datti B, Mathis MJ, Minagar A, Jordan PA, Alexander JS - BMC Gastroenterol (2010)

Annual CD and UC cases by gender/racial group. In fig. 2A the average number of cases seen annually for Crohn's disease is greater amongst Caucasian females than AA females (**, p < 0.01), and is also greater amongst Caucasian M when compared to AA M (***, p < 0.001). In fig. 2B the average number of cases seen annually for UC is greater amongst Caucasian females than Caucasian M (*, p < 0.05), Caucasian females than AA females (**, p < 0.01), and Caucasian M than AA M (*, p < 0.05). * Significantly different with p < 0.05; ** significantly different with p < 0.01; *** significantly different with p < 0.001 using one-way ANOVA, Tukey-Kramer multiple comparison.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2944337&req=5

Figure 2: Annual CD and UC cases by gender/racial group. In fig. 2A the average number of cases seen annually for Crohn's disease is greater amongst Caucasian females than AA females (**, p < 0.01), and is also greater amongst Caucasian M when compared to AA M (***, p < 0.001). In fig. 2B the average number of cases seen annually for UC is greater amongst Caucasian females than Caucasian M (*, p < 0.05), Caucasian females than AA females (**, p < 0.01), and Caucasian M than AA M (*, p < 0.05). * Significantly different with p < 0.05; ** significantly different with p < 0.01; *** significantly different with p < 0.001 using one-way ANOVA, Tukey-Kramer multiple comparison.
Mentions: The annual number of cases per race/gender group was also compared for each condition. In both CD and UC, the average annual number of cases was highest amongst Caucasian F followed by Caucasian M followed by AA F, and finally the lowest number of cases was seen amongst AA M. When comparing this data in CD, Caucasian females had significantly more cases per year than AA females (**, p < 0.01). This was also seen when comparing Caucasian M to AAM (***, p < 0.001) (Fig. 2A). In UC, Caucasian F had significantly more cases per year than Caucasian M (*, p < 0.05) and AA F (**, p < 0.01). When comparing Caucasian M to AA M with UC, Caucasian M had more cases per year (*, p < 0.05) (Fig. 2B). Using the above-mentioned data, the average annual visits per person were calculated by taking the total number of visits per group yearly and dividing that number by the number of cases per respective group. Amongst Crohn's disease patients, AA M made more visits annually to LSUHSC-Shreveport than Caucasian M with this disease (*, p < 0.05) (Fig. 3). Further analysis for the trend of this disease was studied over 9 years for each group.

Bottom Line: Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0).Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios.Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dept of Molecular & Cellular Physiology, 1501 Kings Highway, Shreveport, LA, 71130-3932, USA.

ABSTRACT

Background: Inflammatory Bowel Diseases (IBD) remain significant health problems in the US and worldwide. IBD is most often associated with eastern European ancestry, and is less frequently reported in other populations of African origin e.g. African Americans ('AAs'). Whether AAs represent an important population with IBD in the US remains unclear since few studies have investigated IBD in communities with a majority representation of AA patients. The Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) is a tertiary care medical center, with a patient base composed of 58% AA and 39% Caucasian (W), ideal for evaluating racial (AA vs. W) as well and gender (M vs. F) influences on IBD.

Methods: In this retrospective study, we evaluated 951 visits to LSUHSC-S for IBD (between 2000 to 2008) using non-identified patient information based on ICD-9 medical record coding (Crohn's disease 'CD'-555.0- 555.9 and ulcerative colitis 'UC'-556.0-556.9).

Results: Overall, there were more cases of CD seen than UC. UC and CD affected similar ratios of AA and Caucasian males (M) and females (F) with a rank order of WF > WM > AAF > AAM. Interestingly, in CD, we found that annual visits per person was the highest in AA M (10.7 ± 1.7); significantly higher (* -p < 0.05) than in WM (6.3 ± 1.0). Further, in CD, the female to male (F: M) ratio in AA was significantly higher (*- p < 0.05) (1.9 ± 0.2) than in Caucasians (F:M = 1.3 ± 0.1) suggesting a female dominance in AACD; no differences were seen in UC F: M ratios.

Conclusion: Although Caucasians still represent the greatest fraction of IBD (~64%), AAs with IBD made up >1/3 (36.4%) of annual IBD cases from 2000-2008 at LSUHSC-S. Further studies on genetic and environments risks for IBD risk in AAs are needed to understand differences in presentation and progression in AAs and other 'non-traditional' populations.

Show MeSH
Related in: MedlinePlus