Abstract
Background
Previous studies found that microscopic colitis is inversely associated with Helicobacter pylori infection and that microscopic colitis is characterized by a marked ethnic variation.
Aim
The aim of the present study was to test whether an underlying ethnic variation of H. pylori infection is responsible for the ethnic variation of microscopic colitis.
Methods
The Miraca Life Sciences Database is a large national electronic repository of histopathologic records of patients distributed throughout the entire USA. A cross-sectional study evaluated the influence of age, gender, ethnicity, and histologic diagnosis of H. pylori on the occurrence of microscopic colitis among subjects who underwent esophago-gastro-duodenoscopies plus colonoscopy.
Results
The total study population comprised 228,506 subjects, of whom 28,890 carried a diagnosis of H. pylori gastritis and 3460 microscopic colitis. Female sex, old age, and H. pylori infection exerted the strongest influence on the occurrence of microscopic colitis. In comparison with the population comprising Caucasians and African-Americans, microscopic colitis was less common among subjects of Hispanic (0.34, 0.27–0.47), East Asian (0.13, 0.06–0.22), Indian (0.31, 0.10–0.73), or Middle Eastern descent (0.28, 0.07–0.74). All these ethnic subgroups were also characterized by a higher prevalence of H. pylori than the comparison group. A low prevalence of H. pylori was significantly associated with a high prevalence of microscopic colitis (R 2 = 0.91, p < 0.001).
Conclusion
Ethnic variations in the gastric infection with H. pylori may be partly responsible for the observed ethnic distribution of microscopic colitis.
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References
Sonnenberg A, Genta RM. Inverse Association between Helicobacter pylori gastritis and microscopic colitis. Inflamm Bowel Dis. 2016;22:182–186.
Turner K, Genta RM, Sonnenberg A. Ethnic distribution of microscopic colitis in the United States. Inflamm Bowel Dis. 2015;21:2634–2639.
Elliott MN, Morrison PA, Fremont A, et al. Using the Census Bureau’s surname list to improve estimates of race/ethnicity and associated disparities. Health Serv Outcomes Res Methodol. 2009;9:69–83.
Elliott MN, Fremont A, Morrison PA, et al. A new method for estimating race/ethnicity and associated disparities where administrative records lack self-reported race/ethnicity. Health Serv Res. 2008;43:1722–1736.
Saunders CL, Abel GA, El Turabi A, Ahmed F, Lyratzopoulos G. Accuracy of routinely recorded ethnic group information compared with self-reported ethnicity: evidence from the English Cancer Patient Experience survey. BMJ Open. 2013;3:e002882.
Mathur R, Bhaskaran K, Chaturvedi N, et al. Completeness and usability of ethnicity data in UK-based primary care and hospital databases. J Public Health. 2014;36:684–692.
Krigel A, Turner KO, Makharia GK, Green PH, Genta RM, Lebwohl B. Ethnic variations in duodenal villous atrophy consistent with celiac disease in the United States. Clin Gastroenterol Hepatol. 2016;14:1105–1111.
Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis: the updated Sydney system. Am J Surg Pathol. 1996;120:1161–1181.
Fenoglio-Preiser CM, Noffsinger AE. Gastrointestinal Pathology: An Atlas and Text. 3rd ed. Philadelphia: Wolters Kluwer; 2007:843–847.
Rokkas T, Sechopoulos P, Pistiolas D, Kothonas F, Margantinis G, Koukoulis G. The relationship of Helicobacter pylori infection and colon neoplasia, on the basis of meta-analysis. Eur J Gastroenterol Hepatol. 2013;25:1286–1294.
Wu Q, Yang ZP, Xu P, Gao LC, Fan DM. Association between Helicobacter pylori infection and the risk of colorectal neoplasia: a systematic review and meta-analysis. Colorectal Dis. 2013;15:e352–e364.
Wang F, Sun MY, Shi SL, Lv ZS. Helicobacter pylori infection and normal colorectal mucosa-adenomatous polyp-adenocarcinoma sequence: a meta-analysis of 27 case-control studies. Colorectal Dis. 2014;16:246–252.
Luther J, Dave M, Higgins PD, Kao JY. Association between Helicobacter pylori infection and inflammatory bowel disease: a meta-analysis and systematic review of the literature. Inflamm Bowel Dis. 2010;16:1077–1084.
Wu XW, Ji HZ, Yang MF, Wu L, Wang FY. Helicobacter pylori infection and inflammatory bowel disease in Asians: a meta-analysis. World J Gastroenterol. 2015;21:4750–4756.
Rokkas T, Gisbert JP, Niv Y, O’Morain C. The association between Helicobacter pylori infection and inflammatory bowel disease based on meta-analysis. United Eur Gastroenterol J. 2015;3:539–550.
Graham DY, Opekun AR, Osato MS, et al. Challenge model for Helicobacter pylori infection in human volunteers. Gut. 2004;53:1235–1243.
Yap TW, Gan HM, Lee YP, et al. Helicobacter pylori eradication causes perturbation of the human gut microbiome in young adults. PLoS One. 2016;11:e0151893.
Kienesberger S, Cox LM, Livanos A, et al. Gastric Helicobacter pylori infection affects local and distant microbial populations and host responses. Cell Rep. 2016;16:1395–1407.
Garrett WS. Cancer and the microbiota. Science. 2015;348:80–86.
Genta RM, Sonnenberg A. Helicobacter-negative gastritis: a distinct entity unrelated to Helicobacter pylori infection. Aliment Pharmacol Ther. 2015;41:218–226.
Coldman AJ, Braun T, Gallagher RP. The classification of ethnic status using name information. J Epidemiol Community Health. 1988;42:390–395.
Fiscella K, Fremont AM. Use of geocoding and surname analysis to estimate race and ethnicity. Health Serv Res. 2006;41:1482–1500.
Wei II, Virnig BA, John DA, Morgan RO. Using a Spanish surname match to improve identification of Hispanic women in Medicare administrative data. Health Serv Res. 2006;41:1469–1481.
Mateos P. A review of name-based ethnicity classification methods and their potential in population studies. Popul Space Place. 2007;13:243–263.
Lakha F, Gorman DR, Mateos P. Name analysis to classify populations by ethnicity in public health: validation of Onomap in Scotland. Public Health. 2011;125:688–696.
Ryan R, Vernon S, Lawrence G, Wilson S. Use of name recognition software, census data and multiple imputation to predict missing data on ethnicity: application to cancer registry records. BMC Med Inform Decis Mak. 2012;12:3.
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AS and RMG were involved in the study conception and design. AS, RMG, and KOT helped in data analysis. AS and RMG were involved in writing of manuscript.
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AS has no conflict of interest to declare. KOT and RMG are employed by Miraca Life Sciences, Irving, TX, USA.
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Sonnenberg, A., Turner, K.O. & Genta, R.M. Interaction of Ethnicity and H. pylori Infection in the Occurrence of Microscopic Colitis. Dig Dis Sci 62, 1009–1015 (2017). https://doi.org/10.1007/s10620-016-4441-6
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DOI: https://doi.org/10.1007/s10620-016-4441-6