Foreign-born patients with IBD have ‘milder’ disease, later onset, regardless of race
Click Here to Manage Email Alerts
Key takeaways:
- Black patients were more likely to have Crohn’s and undergo intestinal resection, while Asian women had a lower risk for IBD.
- Foreign-born patients were more likely to have ulcerative colitis and milder disease.
Inflammatory bowel disease phenotype and behavior vary by race and immigration status, with foreign-born patients of all races experiencing less severe disease and later onset than those born in the U.S., researchers reported.
“IBD has historically been a disease of Caucasian populations in Europe and North America, but now we’re seeing it among all races and in people all over the globe, so it’s now important to study how it manifests in different groups,” Lea Ann Chen, MD, senior study author and assistant professor of medicine and pharmacology at Rutgers Robert Wood Johnson Medical School, said in a related press release.
In a single-center, retrospective study published in Gastro Hep Advances, Chen and colleagues compared disease onset, treatment and outcomes by race among 577 patients with IBD treated at New York City’s Bellevue Hospital between 1997 and 2017. Most patients were white (29.8%), followed by Hispanic (27.4%), Black (21.7%) and Asian (13%). Among 260 patients with confirmed country of birth, 69.6% were foreign-born.
Compared with white patients, Asian patients were more likely to be male (OR = 2.63; 95% CI, 1.45-5) and foreign-born (OR = 10.13; 95% CI, 3.34-44.12), while Black patients were more likely to have Crohn’s disease (OR = 1.75; 95% CI, 1.1-2.77) and undergo IBD-related intestinal resection (OR = 2.49; 95% CI, 1.4-4.5). Black patients also were more likely to have had an IBD-related colonic resection (OR = 2.52; 95% CI, 1.24-5.26) vs. white patients.
In addition, Asian patients with ulcerative colitis were more likely to have isolated proctitis (OR = 10.34; 95% CI, 1.58-203.08), and Hispanic patients were more likely to be diagnosed with CD after 40 years of age (OR = 1.44; 95% CI, 1.13-6.53). Researchers observed no significant difference in perianal disease based on race.
By immigration status, foreign-born patients were more likely to have UC than CD (OR = 1.77; 95% CI, 1.04-3.02) and less likely to have pediatric onset (OR = 0.19; 95% CI, 0.08-0.41). Patients born outside of the U.S. also were less likely to have used biologics (OR = 0.43; 95% CI 0.25-0.76), be diagnosed with dermatologic manifestations of disease (OR = 0.12; 95% CI, 0.03-0.41) or to have undergone IBD-related intestinal (OR = 0.39; 95% CI, 0.19-0.83) or colonic (OR = 0.22; 95% CI, 0.09-0.53) resection.
Among patients with CD, those born outside of the U.S. were less likely to have been diagnosed before 16 years of age (OR = 0.12; 95% CI, 0.04-0.34) and more likely to have been diagnosed after age 40 (OR = 9.92; 95% CI, 2.72-64.02).
“Foreign-born patients who immigrate from low-prevalence IBD countries have a milder IBD phenotype compared to patients of the same race who were born in this country,” Chen said in the release. “This is particularly true among Black patients. Those who were born here were far more likely to develop Crohn’s disease and its complications compared to those who were born abroad.”
Chen added: “The difference in case numbers between Asian men and women was striking, and that difference appeared both among U.S.-born and foreign-born patients. It appears that East Asian women — because most of the Asian patients in our study population were East Asian — may have some sort of genetic protection against IBD.”
Reference:
- Inflammatory bowel disease varies by race, sex and birthplace, researchers find. https://rutgershealth.org/news/inflammatory-bowel-disease-varies-race-sex-and-birthplace-researchers-find. Published Jan. 2, 2024. Accessed Jan. 05, 2024.
Collapse
Read more about
Click Here to Manage Email Alerts