Differences in Inflammatory Bowel Disease Characteristics between Hispanics and Non-Hispanic Whites

Abstract

Purpose: Inflammatory bowel disease (IBD) has not been well-studied in Hispanics, the largest minority population in the U.S. A community-based IBD cohort was identified for Community Regional Medical Center, the regional safety-net health system for the California Central Valley, with a population of which 50.9% are Hispanic. We examined potential differences in IBD characteristics between Hispanics and non-Hispanic whites (NHWs), as well as between U.S.-born and foreign-born Hispanics. Methods: A total of 1,216 possible IBD patients, between years 2000 and 2010, were identified by ICD-9 codes from our medical records database. These records were retrospectively reviewed to confirm a diagnosis of IBD and to collect epidemiologic and disease-specific data. This data was analyzed to compare differences between U.S.-born Hispanics, foreign-born Hispanics, and NHWs gender in regards to: age of diagnosis, IBD subtype, disease location, disease behavior, IBD medications, number of hospitalizations. and health insurance status. Chi-square analysis was performed for categorical data, t-test, and analysis of variance done for continuous variables. All p-values are two-sided. Results: A total of 544 IBD patients were identified; 176 were Hispanic (102 U.S.-born and 74 foreignborn). In UC, the mean age at diagnosis was younger in both U.S.-born Hispanics and foreign-born Hispanics compared to NHWs (34 vs. 35 vs. 40, respectively; p=0.018). Hispanics with UC were also predominately male gender, in both U.S.-born Hispanics and foreign-born Hispanics, at 65.1% and 71.0%, respectively, compared to NHWs at 46.9%; p <0.001. The mean number of hospitalizations in UC patients was highest in US-born Hispanics, followed by foreign-born Hispanics and NHWs (1.2 vs. 0.89 vs. 0.63; p<0.005). Immunomodulator use in UC patients was higher in NHWs than US-born and foreign-born Hispanics (29.9% vs. 9.3% vs. 6.2%, p<0.005). Biologic use in UC was also higher in the NHWs than U.S.-born and foreign-born Hispanics (7.2% vs. 0% vs. 1.6%; p<0.005). There were no significant differences in family history of IBD, smoking status, disease location, or colectomy in the UC patients. More NHWs had private health insurance compared to both U.S.-born and foreign-born Hispanics (43.3% vs. 31.4% vs. 26.6%, p<0.001) (See Table 2).Table: Table. Characteristics of patients with Crohn's Disease (CD)Conclusion: In both U.S.-born and foreign-born Hispanics, ulcerative colitis is more predominant in males and diagnosed at a younger age than NHWs. Hispanics with UC had a higher number of hospitalizations compared to NHWs, and lower immunomodulator and biologic use compared to NHWs. There are differences in IBD characteristics among Hispanics and NHWs, which may be due to genetic and/or socio-economic differences, and further studies are needed.Table: Table. Characteristics of patients with Ulcerative Colitis (UC)