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* = Presenting author

DOP004 Ethnicity and country of birth are associated with phenotypic differences in patients with inflammatory bowel disease

Spekhorst L.*1,2, Severs M.3, de Boer N.K.H.4, Festen E.A.M.1,2, Fidder H.H.3, Hoentjen F.5, Imhann F.1,2, de Jong D.J.5, van der Meulen-de Jong A.E.6, Pierik M.7, van der Woude C.J.8, Dijkstra G.1, Ponsioen C.Y.9, Lowenberg M.9, Oldenburg B.3, Weersma R.K.1

1University of Groningen and University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, Netherlands 2University of Groningen and University Medical Center Groningen, Department of Genetics, Groningen, Netherlands 3University Medical Center Utrecht, Department of Gastroenterology and Hepatology, Utrecht, Netherlands 4VU University Medical Center, Department of Gastroenterology and Hepatology, Amsterdam, Netherlands 5University Medical Center St. Radboud, Department of Gastroenterology and Hepatology, Nijmegen, Netherlands 6Leiden University Medical Center, Department of Gastroenterology and Hepatology, Leiden, Netherlands 7University Medical Center Maastricht, Division of Gastroenterology and Hepatology, Maastricht, Netherlands 8Erasmus Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands 9Amsterdam Medical Center, Department of Gastroenterology and Hepatology, Amsterdam, Netherlands

Background

The number of patients with Inflammatory Bowel Disease (IBD) from non-Caucasian descent in Western-Europe is increasing. We aimed to explore the impact of ethnicity and country of birth on IBD the phenotype.

Methods

IBD patients treated in the eight University Medical Centres in the Netherlands and enrolled in the Dutch IBD Biobank were divided into three groups 1) Caucasian patients from West- and Central-European descent (CEU) 2) patients born in the Netherlands or Western-Europe from non-Caucasian descent (non-CEU European born) and 3) non-Caucasian patients born outside Western-Europe that migrated to the Netherlands (non-CEU non-European born), and analyzed for phenotype differences (by chi-square test). Analyses were repeated in an independent Dutch IBD cohort (COIN cohort).

Results

The Dutch IBD Biobank included 2,921 CEU patients and 233 non-CEU patients. Non-CEU patients more often had upper Gastro-Intestinal disease (16% vs. 8%, p=0.001) and anal stenosis (10% vs. 4%, p=0.002). Non-CEU patients born in Europe (n=116) were diagnosed at a younger age than non-CEU patients born outside Europe (n=115) (22.7 vs. 28.9 years old, p<0.001). In the COIN cohort (2,170 Europeans and 98 non-Europeans), non-Europeans more often had fistulas or abscesses (29% vs. 13%, p<0.001), used more anti-TNF-α compounds (45% vs. 20%, p=0.001) and had a lower Health-related Quality of Life (mean IBDQ 161 vs. 177, p<0.001).

Conclusion

Non-CEU patients born in Europe are diagnosed at a younger age with IBD compared to those born outside Europe. Ethnicity and country of birth are associated with different phenotypes in IBD. In clinical IBD care, a tailored approach to the non-CEU patient is warranted.