Abstract
Methods We retrospectively reviewed the medical records of IBD patients who visited Asan Medical center. We used a large, well-characterized referral center-based cohort. The clinical features of IBD patients with body mass index (BMI) over 30 and matched controls with BMI under 30 were compared. Results Among the 6,803 IBD patients enrolled in the Asan IBD Registry between June 1989 and December 2016, we identified 16 patients with Crohn's disease (CD) and 27 patients with ulcerative colitis (UC) whose BMI was over 30 at the time of diagnosis. Their clinical characteristics and course were compared with those of 64 and 108 matched patients with CD and UC, respectively. There were no significant differences in the risk of using steroids (hazards ratio (HR) = 0.633 and P=0.254), immunomodulators (HR = 0.831 and P=0.517), and anti-tumor necrosis factor (TNF) therapy (HR = 1.539 and P=0.351) and risk of bowel resections (HR = 1.858 and P=0.231) between CD patients with BMI over 30 and those with BMI under 30; similarly, UC patients did not show significant differences in the risk of using steroids (HR = 0.613 and P=0.145), immunomodulators (HR = 0.492 and P=0.111), anti-TNF therapy (HR = 0.385 and P=0.095), and risk of colectomy (HR = 0.262 and P=0.104). In the subgroup analysis, under-weight UC patients had a higher cumulative probability of needing steroids (HR = 0.2510 and P=0.042), needing immunomodulators (HR = 0.097 and P=0.014), and a higher risk of receiving colectomy (HR = 0.024 and P=0.019) than obese UC patients. Conclusions Obese IBD patients with CD or UC did not show significantly different clinical features from nonobese IBD patients.
Highlights
Inflammatory bowel disease (IBD) includes a group of diseases featuring recurring and persistent chronic inflammation of the intestine, such as Crohn’s disease (CD) and ulcerative colitis (UC). ese are chronic, debilitating disorders that require lifelong medical treatment and even surgery [1, 2]. e pathogenesis of inflammatory bowel disease (IBD) is not fully understood but is thought to be multifactorial, involving variations in the patient’s genome and environmental factors and alterations in the intestinal microbiota and mucosal immune response [3].Obesity has become an important global public health issue in the current era
According to the Korean Society for the Study of Obesity, a body mass index (BMI) of 30 is classified as stage 2 obesity. e reasons for selecting a cutoff of stage 2 obesity were to avoid the inclusion of a large number of patients with stage 1 obesity and obtain clear results. e Asan IBD registry consisted of 6,803 IBD patients, among whom 6,127 patients had BMI data
Among the 6,803 IBD patients (3,171 with CD and 3,632 with UC), 16 patients with CD and 27 patients with UC had BMI over 30 at the time of diagnosis. e clinical characteristics of the IBD patients according to the Montreal classification are shown in Tables 1 and 2
Summary
Inflammatory bowel disease (IBD) includes a group of diseases featuring recurring and persistent chronic inflammation of the intestine, such as Crohn’s disease (CD) and ulcerative colitis (UC). ese are chronic, debilitating disorders that require lifelong medical treatment and even surgery [1, 2]. e pathogenesis of IBD is not fully understood but is thought to be multifactorial, involving variations in the patient’s genome and environmental factors and alterations in the intestinal microbiota and mucosal immune response [3].Obesity has become an important global public health issue in the current era. Inflammatory bowel disease (IBD) includes a group of diseases featuring recurring and persistent chronic inflammation of the intestine, such as Crohn’s disease (CD) and ulcerative colitis (UC). According to the World Health Organization’s data, the prevalence of over-weight or obesity (body mass index (BMI) > 25 kg/m2) is as high as 35% in the global population, and it is increasing with time [4]. Aim. e prevalence of obesity is increasing globally as is the prevalence of inflammatory bowel disease (IBD). We sought to evaluate the characteristics and prognosis of IBD in patients with obesity. E clinical features of IBD patients with body mass index (BMI) over 30 and matched controls with BMI under 30 were compared. Obese IBD patients with CD or UC did not show significantly different clinical features from nonobese IBD patients
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