Obesity in Inflammatory Bowel Disease

Abstract

Introduction: Although the obesity epidemic is worsening in America, there is a relative paucity of the population level studies reporting the prevalence of obesity among the Inflammatory Bowel Disease (IBD)patients. IBD patients are generally believed to be underweight. Our aim is to examine the obesity trends among the hospitalized IBD patients. Methods: The Nationwide Inpatient Sample database from 2005 to 2014 was examined. Specific ICD -9 Codes for Obesity, IBD were used to compile data. Patient demographic data were also analyzed. Results: The database recorded total of 552887 Inflammatory bowel disease(IBD) admissions during that time period. Among those, 515676(93.27%) were Non-obese IBD and 37211 (6.73%) obese IBD patients. The number of hospital admissions for both Obese and nonobese IBD steadily increased from 2005 to 2014, however, the rate was strikingly high for obese (280% vs 46.22%).The number of admission for obese patients increased from 26.1 to 99.09 per 100,000 admissions compared to 636.55 to 930.39 for Non-Obese Patients.Within the Obese IBD patients, Ulcerative colitis group admissions are increasing at a rapid pace compared the Crohn's (304.95% vs 165.33%), though the majority are Crohn's patients., 62.3% vs 37.7%. The Obese IBD patients tend to be older (mean age of 57.72 vs 51.87) with predominately Caucasian race, However, the AA race is more often associated with Obese IBD than the Non-obese 11.6% vs 10% (OR 1.18, 95% CI 1.14 to 1.22, P < 0.001).Both groups have female preponderance, but more among the Obese IBD patients, 67.2% vs 56.8% (OR:1.57, 95% CI: 1.5 to 1.7, P < 0.001). The number of chronic conditions among the obese patients is higher than non-obese patients (7.5 vs 5.1, with P < 0.001). In spite of the higher prevalence of chronic conditions in Obese patients, mortality among the Nonobese patients is higher (1.6 vs 1.04, OR 1.64, 95% CI 1.4 to 1.8, P< 0.001).Obese IBD patients are more likely to have Metabolic diseases as indicated by higher mean Charleson Deyo Comorbidity score in obese patients, 1.4 vs 0.95. On Logistic Regression, Obesity is associated with Hypertension, Diabetes, Congestive Heart Failure, Myocardial Infarction, Black race, female sex. Conclusion: Even though the obese IBD patients are still not the majority of hospital IBD admissions, but they are the rapidly increasing group. Obese IBD patients tend to be older, more likely to have other comorbid conditions as like general population.Figure: Admission per 100,000.Figure: Obesity trends in Inflammatory bowel disease.FigureTable: Table. Primary diagnosis for patients died among obese and non-obese IBD