SMALL-BOWEL MORPHOLOGY IN BRITISH INDIAN AND AFRO-CARIBBEAN SUBJECTS - EVIDENCE OF TROPICAL ENTEROPATHY

Distal duodenal biopsy specimens taken from 30 white, 35 Indian, and 20 Afro-Caribbean residents of West Birmingham during routine endoscopy for dyspepsia, were assessed by dissecting microscopy and morphometry. Finger-shaped villi were significantly less frequent in the Indian and Afro-Caribbean subjects than in the white subjects when assessed by dissecting microscopy (p < 0.005), and both immigrant groups had decreased mucosal thickness (p < 0.01), villous height (p < 0.001), villous: crypt ratios (p < 0.01) and enterocyte height (p < 0.05) compared with the white group. In the Indian subjects, villous height and villous:crypt ratios correlated significantly with the time since the last visit to the Indian subcontinent (p < 0.005). Serum alkaline phosphatase values were significantly higher in the Indian subjects compared with the whites (p < 0.02), and serum globulins were increased in both the Afro-Caribbean and Indian subjects (p < 0.01). There were no correlations between morphometric indices and body habitus or biochemical or haematological indices and the long term effect of the morphological changes is not clear.