Stabroth-Akil Denia, Leifeld Ludger, Pfützer Roland, Morgenstern Julia, Kruis Wolfgang
Department of Internal Medicine Gastroenterology, Evangelisches Krankenhaus Kalk, Teaching hospital of the University of Cologne, Buchforststrasse 2, 51103, Cologne, Germany.
Int J Colorectal Dis. 2015 Feb;30(2):237-42. doi: 10.1007/s00384-014-2051-3. Epub 2014 Nov 14.
Obesity is a risk factor for inflammatory diseases such as nonalcoholic steatohepatitis, pancreatitis, and Crohn's disease. The effect of being overweight or obese on the severity and clinical course of ulcerative colitis (UC) was assessed in a retrospective analysis of data from 2000-2006.
Two hundred and two consecutive UC patients were categorized according to body mass index (BMI). Patient and disease characteristics were compared between BMI categories using chi-square or Kruskal-Wallis tests. The percentage of patients with active UC, complications, steroid therapy, or immunosuppressive therapy was calculated for each group, and matched pair analyses were performed.
Ten patients (5%) were underweight, 111 (55%) were normal weight, 54 (26.7%) were overweight, and 27 (13.4%) were obese. Pancolitis was inversely related to weight. BMI was also inversely correlated to disease severity, with a significantly smaller proportion of years with chronic active disease among overweight subjects versus normal-weight subjects (17.6 versus 23.9%, p = 0.05). More overweight than normal-weight patients had no chronic active disease in any year (66 versus 49%, p = 0.06), and the proportion of years with disease complications was higher in normal weight than in overweight subjects (1.8 versus 0.4%, p = 0.08). Disease activity during 2000-2006 was higher for underweight versus normal-weight patients, and only 20% of underweight subjects had no hospital admission compared to 80% of normal-weight patients (p = 0.07).
This first study to explore the influence of obesity on UC showed that high BMI had rather a favorable effect on the prognosis, whereas low BMI pointed to a more severe course of the disease.
肥胖是非酒精性脂肪性肝炎、胰腺炎和克罗恩病等炎症性疾病的危险因素。通过对2000年至2006年数据的回顾性分析，评估超重或肥胖对溃疡性结肠炎（UC）严重程度和临床病程的影响。
根据体重指数（BMI）对202例连续的UC患者进行分类。使用卡方检验或克鲁斯卡尔-沃利斯检验比较BMI类别之间的患者和疾病特征。计算每组中活动性UC、并发症、类固醇治疗或免疫抑制治疗患者的百分比，并进行配对分析。
10例患者（5%）体重过轻，111例（55%）体重正常，54例（26.7%）超重，27例（13.4%）肥胖。全结肠炎与体重呈负相关。BMI也与疾病严重程度呈负相关，超重受试者中慢性活动性疾病的年比例明显低于正常体重受试者（17.6%对23.9%，p = 0.05）。超重患者在任何一年中无慢性活动性疾病的比例高于正常体重患者（66%对49%，p = 0.06），正常体重患者疾病并发症的年比例高于超重受试者（1.8%对0.4%，p = 0.08）。2000年至2006年期间，体重过轻患者的疾病活动度高于正常体重患者，体重过轻的受试者中只有20%未住院，而正常体重患者为80%（p = 0.07）。
这项首次探索肥胖对UC影响的研究表明，高BMI对预后有较好的影响，而低BMI则表明疾病病程更严重。
