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Parental Education May Differentially Impact Pediatric Inflammatory Bowel Disease Phenotype Risk
Mahesh Krishna1,2, Aziza Salako1, Tatiana Fofanova3
1Wiess School of Natural Sciences, Rice University, Houston, TX, USA.
Insights
Rising pediatric inflammatory bowel diseases (PIBDs) incidence is linked to socioeconomic factors. Hispanic children show higher UC and IBD-unclassified rates. Income and education correlate with PIBD risk, suggesting environmental influences.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Global incidence of pediatric inflammatory bowel diseases (PIBDs), including Crohn's disease (CD) and ulcerative colitis (UC), is increasing.
- Critical risk factors for this rising incidence remain poorly understood.
- Demographic analysis of PIBD may elucidate developmental origins and inform prevention strategies.
Purpose of the Study:
- To investigate demographic risk factors associated with PIBD incidence in a large metropolitan area.
- To explore correlations between socioeconomic variables and the incidence of pediatric Crohn's disease and ulcerative colitis.
- To identify potential environmental or dietary influences on PIBD development.
Main Methods:
- Retrospective analysis of 488 PIBD patients diagnosed at Texas Children's Hospital.
- Creation of annual incidence maps by ZIP code using ArcGIS and US Census Bureau data.
- Statistical correlation analysis between demographic variables (race/ethnicity, income, education) and PIBD incidence.
Main Results:
- Hispanic children had higher rates of UC and unclassified IBD (IBD-U).
- A positive correlation was found between median household income and PIBD incidence (UC and CD).
- Higher PIBD incidence was observed in areas with higher adult education levels, with variations between CD and UC.
Conclusions:
- Hispanic children in the southern USA present more frequently with UC and IBD-U.
- Household income and adult education levels may indicate environmental/dietary factors influencing PIBD development in urban settings.
- Further research into socioeconomic determinants is warranted for PIBD prevention.
Background:
The incidence of pediatric inflammatory bowel diseases (PIBDs: Crohn's disease [CD], ulcerative colitis [UC]) is on the rise around the world. Yet, the critical risk factors for this rising incidence are not well understood. Demographic characteristics of PIBD may improve our understanding of their developmental origins and aid in prevention.
Methods:
Four hundred eighty-eight consecutive PIBD patients diagnosed at Texas Children's Hospital from 13 counties around Houston were studied. An annual incidence map was created by ZIP code of residence at diagnosis by using ArcGIS and the American Community Survey from the US Census Bureau. Correlation between demographic variables and PIBD incidence was examined. A model to explain incidence from different health factors was created in R.
Results:
Hispanic children were more likely to be diagnosed with UC (P < 0.01) and unclassified IBD (IBD-U) (P < 0.03) compared with other races/ethnicities. A significant positive correlation (r = 0.35, P < 0.0001) between median household income and PIBD incidence was observed (UC: r = 0.23, P < 0.0001; CD: r = 0.22, P = 0.0004). ZIP codes with majority college-educated adults had a higher incidence of PIBD than ZIP codes with majority high school-educated adults (P < 0.0001). Pediatric cases with CD were more common in ZIP codes where the majority of adults were college educated (P < 0.0001). Pediatric cases with UC, however, were more common in ZIP codes where the majority of adults were high school educated (P = 0.0036).
Conclusions:
Hispanic children more commonly present with UC and IBD-U in southern USA. Household income and/or adult education-related environmental/dietary differences may be important in the developmental origins of PIBD in large metro areas, such as Houston.
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