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The influence of Helicobacter pylori on the ethnic distribution of esophageal eosinophilia
Author(s) -
Sonnenberg Am,
Dellon Evan S.,
Turner Kevin O.,
Genta Robert M.
Publication year - 2017
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12370
Subject(s) - eosinophilia , eosinophilic esophagitis , medicine , gastroenterology , helicobacter pylori , population , ethnic group , disease , environmental health , sociology , anthropology
Background Environmental factors associated with ethnicity may contribute to the occurrence of eosinophilic esophagitis. Our study aimed to investigate the influence of Helicobacter pylori on the ethnic variation of esophageal eosinophilia in a large national sample of patients undergoing esophago‐gastro‐duodenoscopy. Methods The Miraca Life Sciences Database is an electronic repository of histopathologic patient records. A case‐control study evaluated the influence of ethnicity on the occurrence of esophageal eosinophilia and how age, gender, and histologic diagnosis of H. pylori modify this relationship. Results The total study population comprised 596 479 subjects, of whom 25 969 harbored a diagnosis of esophageal eosinophilia. Young age, male sex, and H. pylori infection in declining order exerted the strongest influence on the occurrence of esophageal eosinophilia. In comparison with the population comprising of Caucasians and African‐Americans, esophageal eosinophilia was less common among patients of African (OR=0.10, 95% CI=0.01‐0.46), Middle Eastern (0.22, 0.15‐0.31), East Asian (0.32, 0.26‐0.38), Indian (0.28, 0.21‐0.37), Hispanic (0.40, 0.37‐0.43), or Jewish descent (0.58, 0.51‐0.66), but more common among patients of Northern European descent (1.25, 1.07‐1.45). With the exception of Northern Europeans, all ethnic subgroups were 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 esophageal eosinophilia ( R 2 =0.90, P <.001). Conclusion Esophageal eosinophilia prevalence markedly varies by patient ethnicity. As there is a strong inverse correlation between H. pylori and esophageal eosinophilia, H. pylori infection may be in part responsible for the observed ethnic distribution of esophageal eosinophilia.