The Impact of Ethnicity and Country of Birth on Inflammatory Bowel Disease Phenotype: a Prospective Cohort Study

J Crohns Colitis. 2017 Dec 4;11(12):1463-1470. doi: 10.1093/ecco-jcc/jjx098.

Abstract

Background and aims: The number of patients with inflammatory bowel disease [IBD], of non-Caucasian descent in Western Europe, is increasing. We aimed to explore the impact of ethnicity and country of birth on IBD phenotype.

Methods: IBD patients treated in the eight University Medical Centers in The Netherlands [Dutch IBD Biobank] were divided into two groups according to their ethnicity: 1] Caucasian patients of Western and Central European descent [CEU]; and 2] patients of non-Caucasian descent [non-CEU]. The non-CEU group was subdivided according to country of birth, into: born in The Netherlands or Western Europe [non-CEU European born]; or born outside Western-Europe who migrated to The Netherlands [non-CEU non-European born]. Both comparisons were analysed for phenotype differences [by chi-square test].

Results: The Dutch IBD Biobank included 2921 CEU patients and 233 non-CEU patients. Non-CEU Crohn's disease [CD] patients more often had upper gastro-intestinal disease [16% vs 8%, p = 0.001] and anal stenosis [10% vs 4%, p = 0.002] than CEU CD patients. The use of anti-tumour necrosis factor [TNF] agents and immunomodulators was higher in non-CEU IBD patients than in CEU IBD patients [45% vs 38%, p = 0.042] and [77% vs 66%, p = 0.001], respectively. Non-CEU IBD patients born in Europe [n = 116] were diagnosed at a lower age than non-CEU IBD patients born outside Europe [n = 115] [at 22.7 vs 28.9 years old, p < 0.001].

Conclusion: Non-Caucasians had more severe disease behaviour than Caucasians. Non-CEU patients born in Europe were diagnosed at a lower age with IBD than those born outside Europe who migrated to The Netherlands.

Keywords: Crohn’s disease; ethnicity; phenotype; ulcerative colitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Anal Canal / pathology
  • Colitis, Ulcerative / ethnology*
  • Colitis, Ulcerative / genetics
  • Colitis, Ulcerative / therapy
  • Constriction, Pathologic / ethnology
  • Crohn Disease / ethnology*
  • Crohn Disease / genetics
  • Crohn Disease / therapy
  • Digestive System Surgical Procedures / statistics & numerical data
  • Europe / ethnology
  • Female
  • Humans
  • Intestinal Fistula / ethnology*
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Phenotype*
  • Prospective Studies
  • Residence Characteristics*
  • White People / statistics & numerical data