Influence of Race and Gender on Eosinophilic Esophagitis
Male patients with EoE were diagnosed at a younger age than females, but this was not statistically significant (25±19 vs. 29±20 years; P=0.19; Table 1). However, a higher proportion of males were diagnosed under the age of 18 in childhood as compared with females (48 vs. 36%, P=0.05). Males were also more likely than females to report dysphagia or food impaction (71 vs. 53%, P=0.02 and 35 vs. 20%, P=0.05, respectively), but less likely to report abdominal pain or nausea (17 vs. 40%, P=0.001 and 9 vs. 28%, P=0.002, respectively). There was no significant association between gender and atopic disease, race, or other reported symptoms.
On endoscopic evaluation, there were no significant difference between males and females with EoE; indication for endoscopy, endoscopic findings including rings, linear furrows, white plaques/exudates, or esophageal strictures were similar between the two groups (Table 2).
The maximum esophageal epithelial eosinophil count in males and females was similar (105±96 vs. 109±111 eos/h.p.f., P=0.80; Table 3). Other histologic findings, including the presence of eosinophil degranulation, eosinophilic microabscesses, or lamina propria fibrosis, also did not differ between the groups.
After stratification by age (Supplementary Table), the proportion of patients with dysphagia was similar for adult Caucasians and adult African Americans, but in children, there was a trend toward more dysphagia in Caucasians (52 vs. 27%, P=0.07). Failure-to-thrive remained more common in African-American children (40 vs. 15%, P=0.03). The proportion of patients with esophageal rings was greater in Caucasian adults than African-American adults (66 vs. 30%, P=0.02), and was also more common in Caucasian children, though this was not significant (11 vs. 0%, P=0.19). On multivariate analysis, odds of failure-to-thrive were increased for African Americans (odds ratio: 3.48, 95% confidence interval: 1.08–11.3), but dysphagia and esophageal rings were not independently associated with race.
For gender (Supplementary Table), dysphagia and food impaction were more common in males regardless of age, but this was only statistically significant for adult males with dysphagia (93 vs. 68%, P=0.001). Abdominal pain and nausea were less common in adults males compared with females (6 vs. 38%, P<0.001 and 5 vs. 27%, P=0.004), but there were no differences in these symptoms for children. On multivariate analysis, odds of abdominal pain remained lower for males (odds ratio: 0.25, 95% confidence interval: 0.09–0.72), and younger age was also independently associated with male gender (odds ratio: 1.03, 95% confidence interval: 1.01–1.05).
EoE and Gender
Male patients with EoE were diagnosed at a younger age than females, but this was not statistically significant (25±19 vs. 29±20 years; P=0.19; Table 1). However, a higher proportion of males were diagnosed under the age of 18 in childhood as compared with females (48 vs. 36%, P=0.05). Males were also more likely than females to report dysphagia or food impaction (71 vs. 53%, P=0.02 and 35 vs. 20%, P=0.05, respectively), but less likely to report abdominal pain or nausea (17 vs. 40%, P=0.001 and 9 vs. 28%, P=0.002, respectively). There was no significant association between gender and atopic disease, race, or other reported symptoms.
On endoscopic evaluation, there were no significant difference between males and females with EoE; indication for endoscopy, endoscopic findings including rings, linear furrows, white plaques/exudates, or esophageal strictures were similar between the two groups (Table 2).
The maximum esophageal epithelial eosinophil count in males and females was similar (105±96 vs. 109±111 eos/h.p.f., P=0.80; Table 3). Other histologic findings, including the presence of eosinophil degranulation, eosinophilic microabscesses, or lamina propria fibrosis, also did not differ between the groups.
Stratification by Age and Multivariate Analyses
After stratification by age (Supplementary Table), the proportion of patients with dysphagia was similar for adult Caucasians and adult African Americans, but in children, there was a trend toward more dysphagia in Caucasians (52 vs. 27%, P=0.07). Failure-to-thrive remained more common in African-American children (40 vs. 15%, P=0.03). The proportion of patients with esophageal rings was greater in Caucasian adults than African-American adults (66 vs. 30%, P=0.02), and was also more common in Caucasian children, though this was not significant (11 vs. 0%, P=0.19). On multivariate analysis, odds of failure-to-thrive were increased for African Americans (odds ratio: 3.48, 95% confidence interval: 1.08–11.3), but dysphagia and esophageal rings were not independently associated with race.
For gender (Supplementary Table), dysphagia and food impaction were more common in males regardless of age, but this was only statistically significant for adult males with dysphagia (93 vs. 68%, P=0.001). Abdominal pain and nausea were less common in adults males compared with females (6 vs. 38%, P<0.001 and 5 vs. 27%, P=0.004), but there were no differences in these symptoms for children. On multivariate analysis, odds of abdominal pain remained lower for males (odds ratio: 0.25, 95% confidence interval: 0.09–0.72), and younger age was also independently associated with male gender (odds ratio: 1.03, 95% confidence interval: 1.01–1.05).
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