The Association Between Crohn?s Disease Phenotype And Race In The Western Cape, South Africa, Defined By The Montreal Classification System | 29434
Journal of Gastrointestinal & Digestive System
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Significant differences in CD susceptibility genotype have been identified between the racial groups in South Africa; however
there is no recent data for such groups describing the disease phenotype or clinical features. We performed a cross sectional
examination of all consecutive Crohn?s disease (CD) patients seen at 2 large inflammatory bowel disease (IBD) referral centers in the
Western Cape, South Africa between September 2011- January 2013. Numerous demographic and clinical variables at diagnosis and
date of study enrolment were identified via; investigator-administered questionnaire; clinical examination; and patient case notes.
Using predefined definitions, disease behaviour was stratified as ?complicated? or ?uncomplicated?. All statistical analysis included only
White and Coloured subjects, due to the small number of Black subjects. Over an approximate 17 month period we identified; 35
(18%) White; 152 (78%); Coloured; 7(4%) Black subjects. On multiple logistic regression analysis there was no significant difference
between Coloured and White subjects with regard to CD location, or CD behaviour at diagnosis. However, significantly more
Coloured subjects had developed ?complicated? CD (60% vs. 9%) during the disease course compared to Whites. In addition, all
Black subjects developed ?complicated? CD within 3 years after diagnosis. There was no significant inter-racial difference in terms of
extraintestinal manifestations or medical management. A low proportion of IBD family history was observed among the non-White
subjects. Compared to earlier reports, our data suggests a rising CD prevalence among the non-White populations. These observed
trends lend support to both different susceptibility genes and variable environmental interactions between racial groups.
Abigail Basson has completed her PhD from the University of the Western Cape, South Africa, where she is presently a Lecturer of Nutrigenomics and Medical
Nutrition Therapy. She received her MSc degree in Nutrition Science from New York University (USA) and also holds a Postgraduate qualification in Nutrigenomics
from the University of Arizona. She has authored several publications in reputed journals and is serving as an Editorial Board Member of repute.
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