Journal
AMERICAN JOURNAL OF GASTROENTEROLOGY
Volume 104, Issue 9, Pages 2233-2240Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/ajg.2009.267
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Funding
- NCRR NIH HHS [5P20RR011126, M01 RR000052, P20 RR011126, UL1 RR024139, RR024139, RR00052, M01 RR000052-370565] Funding Source: Medline
- NIDDK NIH HHS [DK062431, U01 DK062422-04, DK062432, U01 DK062422-03, R01 DK064869-06A1, DK072373, U01 DK062422-01, R01 DK076025, U01 DK062422-05, U01 DK062420-07, U01 DK062420-04, R01 DK072373-02, U01 DK062420-02, U01 DK062429-01, U01 DK062422-02, U01 DK062431, R01 DK076025-02, U01 DK062429-07, U01 DK062431-06, U01 DK062422-08S1, R01 DK076025-01A1, DK062422, U01 DK062413, U01 DK062422, U01 DK062422-08, U01 DK062429, U01 DK062431-05, U01 DK062432, DK076025, U01 DK062420-06, U01 DK062420, DK062413, DK062429, U01 DK062420-01, R01 DK072373-03, U01 DK062429-03, DK064869, U01 DK062429-02, U01 DK062431-04, U01 DK062429-04, U01 DK062423-01, R01 DK064869, U01 DK062422-06, U01 DK062420-05, DK062423, U01 DK062431-07, U01 DK062429-05, R01 DK072373-01A1, DK062420, U01 DK062429-08, U01 DK062431-02, U01 DK062431-03, U01 DK062422-07, R01 DK072373, U01 DK062432-08, U01 DK062431-01, U01 DK062423, U01 DK062420-03, U01 DK062429-06] Funding Source: Medline
- NIMH NIH HHS [R01 MH057881, MH057881, R37 MH057881] Funding Source: Medline
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OBJECTIVES: Phenotype characteristics of inflammatory bowel disease (IBD) may differ significantly among ethnic subpopulations. The aim of this study was to characterize the IBD phenotype in French Canadians, the most prominent founder population in North America. METHODS: Using well-characterized phenotype data in the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)-IBD Genetics Consortium repository on patients with IBD, we compared phenotypic characteristics of 202 French Canadians with those of 1,287 other Caucasian patients. These included diagnosis, anatomical location, disease behavior, extraintestinal manifestations, surgical history, and family history of IBD. RESULTS: French-Canadian patients with Crohn's disease (CD) were less likely to have stricturing disease (11 vs. 21 %, P = 0.005; odds ratio (OR): 0.45, 95 % confidence interval (95 % CI): 0.24-0.85). Using a stringent definition of ethnicity (three out of four grandparents being French Canadians, as opposed to self-report, n = 148), French Canadians had a tendency toward developing fistulizing CD (37 vs. 28 %, P = 0.07), and there was an increased prevalence of sacroiliitis among those with IBD (4 vs. 2 %, P = 0.045). Among French Canadians, the numbers of current smokers in CD (40 vs. 25 %, P = 0.006) and former smokers in ulcerative colitis (UC) (35 vs. 20 %, P = 0.03) were significantly higher. The prevalence of one of the three main variants of nucleotide-binding oligomerization domain containing 2 (NOD2) single-nucleotide polymorphisms (SNPs)-among French-Canadian CD patients was 43.2 %. The 3020insC SNP correlated with small bowel disease in French Canadians (75 vs. 0 %, P = 0.006). CONCLUSIONS: French Canadians show an IBD phenotype profile distinct from other Caucasian IBD populations, with an accentuated association between smoking status and IBD. This unique profile may have implications regarding the need for a different approach to the management of IBD in this population.
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