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Latin Americans and US Hispanics show differences in IBD phenotype: a systematic review with meta-analysis
  1. Danny Juan Avalos1,
  2. Jinendra Satiya2,
  3. Alberto Contreras3,
  4. Shivani Trivedi4,
  5. Luis Alvarado5,
  6. Christopher Dodoo5,
  7. Alok Kumar Dwivedi6,
  8. Marc J. Zuckerman3
  1. 1 Gastroenterology, Miami Gastro LLC, Homestead, Florida, USA
  2. 2 Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Division of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, Texas, USA
  4. 4 Department of Internal Medicine, Largo Medical Center, Largo, Florida, USA
  5. 5 Biostatistics and Epidemiology Consulting lab, Texas Tech University Health Sciences Center, El Paso, Texas, USA
  6. 6 Department of Molecular and Translational Medicine, Division of Biostatistics & Epidemiology, Texas Tech University Health Sciences Center, El Paso, Texas, USA
  1. Correspondence to Dr Danny Juan Avalos, Gastroenterology, Miami Gastro LLC, Homestead, Florida, USA; djavalos{at}gmail.com

Abstract

Latin America has experienced a rise in the prevalence and incidence of inflammatory bowel disease (IBD). Differences in IBD phenotype between Hispanics in Latin America and those in the USA have not been described. We conducted a systematic review with meta-analysis of population-based and cohort studies comparing the phenotype of ulcerative colitis (UC) and Crohn’s disease (CD) in Latin Americans and US Hispanics. A systematic search was conducted up to March 2019 using MEDLINE, EMBASE and Google Scholar. Inclusion criterion includes studies describing IBD phenotype in Latin Americans or in US Hispanics. Exclusion criterion includes prevalence or incidence studies not describing phenotype. A random effects model was chosen “a priori” for analysis of pooled proportions. A total of 46 studies were included from Latin America and 7 studies from the USA. The predominant IBD subtype in Latin America was UC with a more balanced UC:CD ratio noted in Puerto Rico (0.53) and Brazil (0.56). UC-related extensive colitis was more common in US Hispanics (0.64) than in Latin Americans (0.38), p<0.001. CD phenotype was similar between US Hispanics and Latin Americans. UC is the predominant IBD subtype in Latin America, with the exception of Puerto Rico and Brazil which demonstrate a more balanced UC:CD ratio. In UC, extensive colitis was more frequently seen in US Hispanics than in Latin Americans. CD phenotype was similar in both US Hispanics and Latin Americans.

  • inflammatory bowel diseases
  • phenotype

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. This is a meta-analysis. Data were gathered from previously published and unpublished studies.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. This is a meta-analysis. Data were gathered from previously published and unpublished studies.

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Footnotes

  • Twitter @DannyJAvalos, @JinendraSatMD

  • Contributors Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: DJA, JS, AKD, CD, LA, ST, AC. Drafting the work or revising it critically for important intellectual content: DJA, JS, MZ. Final approval of the version to be published: DJA, JS, MZ, AKD, CD, LA. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: DJA, JS, MZ, AKD, CD, LA, AC. Responsible for the overall content as the guarantor: DJA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AKD is an Associate Editor for the Journal of Investigative Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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