Inflammatory bowel disease and African Americans: A systematic review
Inflammatory bowel disease and African Americans: A systematic review
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DOI：
10.1002/ibd.20389
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发表时间：
2008-07-01
影响因子：
4.9
通讯作者：
Galandiuk, Susan
中科院分区：
文献类型：
--
作者：
Mohid, Suhal S.;Mulholl, Aaron M.;Galandiuk, Susan
背景：炎症性肠病（IBD）由克罗恩病（CD）和溃疡性结肠炎（UC）组成。关于非裔美国人是否有更严重的病程、表现和更频繁的肠外表现（EIM），有相互矛盾的报道。我们通过进行系统回顾来检验这种关系的确切性质。方法采用预定义的纳入标准，检索多个医疗数据库和灰色文献。8份报告符合纳入标准。使用蒙特利尔分类中定义的参数和是否存在EIM，我们比较了非洲裔美国人和白种人的IBD。结果：从8份报告中收集了2000多例IBD病例，其中非洲裔美国人占17%。非裔美国人和白种人的IBD类型分布相似，两组中CD比UC更常见（分别为76%对68%，24%对32%）。对于乳糜泻，两组均更频繁地出现非狭窄性和非穿透性疾病行为（55%对41%），回肠结肠疾病部位（42%对38%）和肛周疾病的发生率相似（26%对29%）。在UC患者中，直肠炎是两个种族中最常见的首发症状。关节并发症是最常见的EIM在非洲裔美国人（52%）和白种人（60%）。结论：本研究消除了非裔美国人IBD患者通常比白种人有更多的结肠疾病、更严重的疾病行为和更多的肛周疾病的观点。与白种人相比，非裔美国人也有相似的EIMs种类和频率。
Background: Inflammatory bowel disease (IBD) is comprised of Crohn's disease (CD) and ulcerative colitis (UC). There are conflicting reports on whether African Americans have a more severe disease course, presentation, and more frequent extraintestinal manifestations (EIM). We examined the precise nature of this relationship by conducting a systematic review.Methods: Using predefined inclusion criteria we searched multiple healthcare databases and Grey literature. Eight reports met the inclusion criteria. Using the parameters as defined in the Montreal classification and the presence or absence of EIM, we compared IBD in African Americans and Caucasians.Results: Over 2000 IBD cases were pooled from 8 reports with African Americans comprising 17%. African Americans and Caucasians had similar distribution of types of IBD, with CD being more common than UC in both groups (CD 76% versus 68% and UC 24% versus 32%, respectively). With respect to CD, both groups presented with nonstricturing and nonpenetrating disease behavior (55% versus 41%) more frequently and had similar rates of ileocolonic disease location (42% versus 38%), and presence of perianal disease (26% versus 29%). In UC patients, proctitis was the most frequent initial presentation in both races. Joint complications were the most frequent EIM in both African Americans (52%) and Caucasians (60%).Conclusions: This study dispels the commonly held views that African Americans with IBD generally have more colonic disease, more severe disease behavior, and more perianal disease than Caucasians. African Americans also have similar variety and frequency of EIMs as compared to Caucasians.