Visceral Fat Is Increased in Individuals With Crohnʼs Disease: A Comparative Analysis With Healthy Controls

Abstract

BACKGROUND: The prevalences of overweight (20-40%) and obesity (15-30%) among individuals with inflammatory bowel disease (IBD) are similar to those observed in the general population. The accumulation of visceral fat is a potentially inflammatory factor because it increases the production of inflammation mediators and free fatty acids. It also may be linked to an increased endotoxinemia associated with the augmentation in the intestinal permeability. It is known that obesity is associated with a chronic inflammatory state, but few studies have evaluated the visceral fat content and its role in individuals with Crohn's disease (CD). Aim: To compare the nutritional status, body composition and proportion of visceral fat between CD individuals and a control group (CG). METHODS: A cross-sectional study that enrolled individuals with CD and a CG comprised of healthy volunteers. The stratification according to the nutritional status was carried out by means of the body mass index (BMI). The percentage of body fat percentage (%BF) and the visceral fat (VF) were estimated by means of DEXA (dual energy X-ray absorption). The visceral fat proportion was evaluated by means of the VF/BMI and VF/%BF ratios. RESULTS: A total of 78 individuals were included. The control group was comprised of 28 healthy subjects aged 35.39±10 years old; 60.7% were women; mean BMI: 23.94±3.34 kg/m2; mean VF: 511.82±448.68 grams(g); mean CRP: 0.81±1.78 ng/mL. The CD group was comprised of 50 patients; 11 (22%) were underweight (BMI:18.20±1.97 kg/m2; %BF: 24.46±10.01; VF: 217.18±218.95g; CRP: 4,12±4,84); 18 (36%) presented normal weight (BMI: 22.43±1.48kg/m2; %BF: 30.92±6.63; VF: 542.00±425.47 grams and CRP:4.40±1.78); 21(42%) were overweight or obese (BMI: 29.48±3.78kg/m2; %BF: 39.91±7.33; VF: 1525.23±672.76 grams and CRP: 1.33±2.06). The VF/BMI ratio was higher in the CD group when compared to CG (32.41 ± 24.63 vs. 20.01±16.23 grams per BMI point; P=0.02); likewise, the VF/%BF was also higher in the CD group (35.21±23.33 vs. 15.60±12.55 grams per percentage point; P<0.001). It means that, in CD subjects, there is a disproportion of visceral fat distribution when compared with CG group. CONCLUSION(S): Among individuals with CD, BMI presents a direct correlation with the visceral fat content. The fat distribution in the CD Group was disproportionate when compared to the CG. These results indicate the presence of an adiposopathy in CD subjects, which is evidenced by a higher visceral fat tissue volume.