Abstract
Background: The prevalence of some immune-mediated diseases (IMDs) shows distinct differences between populations of different ethnicities. The aim of this study was to determine if the age at diagnosis of common IMDs also differed between different ethnic groups in the UK, suggestive of distinct influences of ethnicity on disease pathogenesis.
Methods: This was a population-based retrospective primary care study. Linear regression provided unadjusted and adjusted estimates of age at diagnosis for common IMDs within the following ethnic groups: White, South Asian, African-Caribbean and Mixed-race/Other. Potential disease risk confounders in the association between ethnicity and diagnosis age including sex, smoking, body mass index and social deprivation (Townsend quintiles) were adjusted for. The analysis was replicated using data from UK Biobank (UKB).
Results: After adjusting for risk confounders, we observed that individuals from South Asian, African-Caribbean and Mixed-race/Other ethnicities were diagnosed with IMDs at a significantly younger age than their White counterparts for almost all IMDs. The difference in the diagnosis age (ranging from 2 to 30 years earlier) varied for each disease and by ethnicity. For example, rheumatoid arthritis was diagnosed at age 49, 48 and 47 years in individuals of African-Caribbean, South Asian and Mixed-race/Other ethnicities respectively, compared to 56 years in White ethnicities. The earlier diagnosis of most IMDs observed was validated in UKB although with a smaller effect size.
Conclusion: Individuals from non-White ethnic groups in the UK had an earlier age at diagnosis for several IMDs than White adults.
Methods: This was a population-based retrospective primary care study. Linear regression provided unadjusted and adjusted estimates of age at diagnosis for common IMDs within the following ethnic groups: White, South Asian, African-Caribbean and Mixed-race/Other. Potential disease risk confounders in the association between ethnicity and diagnosis age including sex, smoking, body mass index and social deprivation (Townsend quintiles) were adjusted for. The analysis was replicated using data from UK Biobank (UKB).
Results: After adjusting for risk confounders, we observed that individuals from South Asian, African-Caribbean and Mixed-race/Other ethnicities were diagnosed with IMDs at a significantly younger age than their White counterparts for almost all IMDs. The difference in the diagnosis age (ranging from 2 to 30 years earlier) varied for each disease and by ethnicity. For example, rheumatoid arthritis was diagnosed at age 49, 48 and 47 years in individuals of African-Caribbean, South Asian and Mixed-race/Other ethnicities respectively, compared to 56 years in White ethnicities. The earlier diagnosis of most IMDs observed was validated in UKB although with a smaller effect size.
Conclusion: Individuals from non-White ethnic groups in the UK had an earlier age at diagnosis for several IMDs than White adults.
| Original language | English |
|---|---|
| Article number | 346 |
| Number of pages | 12 |
| Journal | BMC medicine |
| Volume | 20 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 13 Oct 2022 |
Bibliographical note
Funding Information:This work was supported by a grant from EULAR and FOREUM. JML and KR are supported by the NIHR Birmingham BRC. DTZ was supported by the MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research.
The views expressed here are those of the authors and not necessarily the NHS, NIHR or Department of Health and Social Care.
Publisher Copyright:
© 2022, The Author(s).
Keywords
- Autoimmune inflammatory diseases
- Immune-mediated diseases
- Ethnicity
- South Asian
- African-Caribbean
- Diagnosis
- Rheumatic diseases
- Ageing
ASJC Scopus subject areas
- Medicine(all)