Harper Jason W, Zisman Timothy L
Jason W Harper, Department of Gastroenterology, Swedish Medical Center, Seattle, WA 98195, United States.
World J Gastroenterol. 2016 Sep 21;22(35):7868-81. doi: 10.3748/wjg.v22.i35.7868.
Inflammatory bowel disease (IBD) is a chronic inflammatory condition of unknown etiology that is thought to result from a combination of genetic, immunologic and environmental factors. The incidence of IBD has been increasing in recent decades, especially in developing and developed nations, and this is hypothesized to be in part related to the change in dietary and lifestyle factors associated with modernization. The prevalence of obesity has risen in parallel with the rise in IBD, suggesting a possible shared environmental link between these two conditions. Studies have shown that obesity impacts disease development and response to therapy in patients with IBD and other autoimmune conditions. The observation that adipose tissue produces pro-inflammatory adipokines provides a potential mechanism for the observed epidemiologic links between obesity and IBD, and this has developed into an active area of investigative inquiry. Additionally, emerging evidence highlights a role for the intestinal microbiota in the development of both obesity and IBD, representing another potential mechanistic connection between the two conditions. In this review we discuss the epidemiology of obesity and IBD, possible pathophysiologic links, and the clinical impact of obesity on IBD disease course and implications for management.
炎症性肠病（IBD）是一种病因不明的慢性炎症性疾病，被认为是由遗传、免疫和环境因素共同作用所致。近几十年来，IBD的发病率一直在上升，尤其是在发展中国家和发达国家，据推测这部分与现代化相关的饮食和生活方式因素的变化有关。肥胖症的患病率与IBD的上升同步增加，表明这两种疾病之间可能存在共同的环境联系。研究表明，肥胖会影响IBD患者以及其他自身免疫性疾病患者的疾病发展和对治疗的反应。脂肪组织产生促炎脂肪因子这一观察结果为肥胖与IBD之间已观察到的流行病学联系提供了一种潜在机制，并且这已发展成为一个活跃的研究领域。此外，新出现的证据凸显了肠道微生物群在肥胖和IBD发展中的作用，这代表了这两种疾病之间的另一种潜在机制联系。在本综述中，我们讨论了肥胖和IBD的流行病学、可能的病理生理联系，以及肥胖对IBD病程的临床影响及其对管理的意义。
