@article{MRA, author = {Raguraj Chandradevan and Porsha Okiye and Chakravarthy Nulu and Bobak Moazzami and Humberto Sifuentes}, title = { Racial Disparities in Clinical Manifestation of Crohn’s disease}, journal = {Medical Research Archives}, volume = {13}, number = {3}, year = {2025}, keywords = {}, abstract = {Introduction: This study aims to evaluate and compare the clinical manifestations and disease progression of CD in African Americans (AA) and Caucasians \{CA\}. Methods: We conducted a single-center cross-sectional study of all patients with CD, both hospitalized and seen as outpatient, treated from 2019 to 2024. Chart reviews were used to identify disease location, and perianal disease, strictures, penetrating natures, endoscopy and surgical history, extra intestinal manifestation, demographics, treatment and medication use. Patients with ulcerative colitis or indeterminant colitis were excluded. Results: A total of 167 patients were identified, comprising 43% AA and 56% Ca. Mean age of diagnosis was 43±14.56 for AA and 47±15.71 for Ca. The average measured BMI was higher in AA (28.55±8.07) than Ca (26.01±5.93) (p<0.01; Table 1).  Although there was no significant gender difference in the overall diagnosis of CD, a higher prevalence was observed among females in AA (F/M ratio: 43/27 in AAs vs. 50/45 in Ca). CDs related surgeries occurred in 71% of AA and 56% of Ca. Time from diagnosis to surgery was 17 years for AA and 15 years for Ca with a wide range of standard deviation. No significance differences noted in extraintestinal manifestations, undergoing surgeries, treatment modalities, insurances and perianal disease. AA were more likely to have penetrating phenotype (B3) and less likely to have inflammatory (B1) and stricturing phenotypes (B2) as compared to Caucasians (p<0.005; Table 1).  Multivariate logistic regression analysis revealed that the odds of having a B3 phenotype compared to a B1 phenotype were approximately 2.43 times higher for AA compared to Ca (CI: 1.26-4.69) after adjusting for age, sex and BMI. In a subgroup analysis of those with the B3 phenotype, AA were less likely to use steroids compared to Ca (32% Vs 53%, p < 0.05). Discussion: This study showed that AA were more likely to develop complicated CD over time compared to Ca. Higher BMI was noted among AA, however not correlated with complicated CD. AA were diagnosed younger, had a female predominance, longer time from diagnosis to surgery and underwent more surgeries. These findings suggest that CD may manifest differently in AA, though socioeconomic status, healthcare access, and awareness of the disease process may also play a role.}, issn = {2375-1924}, doi = {10.18103/mra.v3i3.6375}, url = {https://esmed.org/MRA/mra/article/view/6375} }