*Gastroenterology Service, Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland; †Uniformed Services University of Health Sciences, Bethesda, Maryland; and ‡Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland.
Inflamm Bowel Dis. 2017 Sep;23(9):1637-1642. doi: 10.1097/MIB.0000000000001187.
Crohn's disease (CD) is a chronic condition associated with the risk of malabsorption. The incidence of obesity worldwide is increasing, and the effect of obesity on patients with CD is unknown. We aim to identify traits related to obesity in a cohort of patients with CD.
We conducted a retrospective study of 209 adult patients with CD. Age, Montreal disease classification, sex, race, duration of disease, erythrocyte sedimentation rate, C-reactive protein levels, physician global assessment, endoscopic appearance, histologic activity, medication use, and body mass index (BMI) were collected about each patient.
The mean age was 43.4 ± 14.9 years; 68.9% were white, and 51.7% were male. The mean duration of disease was 11.0 ± 10.6 years. The mean BMI was 26.8 ± 5.7: underweight 7.7%; normal weight 29.3%; overweight 38.0%; and obese 25%. Patients with higher BMI were more likely to have extraintestinal manifestations (EIM) (P = 0.005) and more likely to have nonarthralgia extraintestinal manifestations (P = 0.047). There was a linear association between proximal CD and decreasing BMI (underweight 31.3%, normal weight 14.8%, overweight 15.0%, obese 7.7%; P = 0.046). There was no difference in BMI between patients with and without perianal disease (P = 0.216).
Most patients were overweight or obese, which correlates with national population trends. Our data suggest disease location plays a role in weight modulation in patients with CD. Increased extraintestinal manifestations in patients with high BMI suggests that the chronic inflammation associated with obesity may play a role in extraintestinal inflammation.
克罗恩病（CD）是一种与吸收不良风险相关的慢性疾病。全球肥胖的发病率正在上升，肥胖对 CD 患者的影响尚不清楚。我们旨在确定 CD 患者队列中与肥胖相关的特征。
我们对 209 例成年 CD 患者进行了回顾性研究。收集了每位患者的年龄、蒙特利尔疾病分类、性别、种族、疾病持续时间、红细胞沉降率、C 反应蛋白水平、医生总体评估、内镜表现、组织学活动、药物使用和体重指数（BMI）。
平均年龄为 43.4 ± 14.9 岁；68.9%为白人，51.7%为男性。疾病平均持续时间为 11.0 ± 10.6 年。平均 BMI 为 26.8 ± 5.7：体重不足 7.7%；正常体重 29.3%；超重 38.0%；肥胖 25%。BMI 较高的患者更有可能出现肠外表现（EIM）（P = 0.005），并且更有可能出现非关节肠外表现（P = 0.047）。近端 CD 与 BMI 降低呈线性关联（体重不足 31.3%，正常体重 14.8%，超重 15.0%，肥胖 7.7%；P = 0.046）。有肛周疾病和无肛周疾病的患者之间 BMI 没有差异（P = 0.216）。
大多数患者超重或肥胖，这与全国人口趋势相符。我们的数据表明，疾病部位在 CD 患者的体重调节中起作用。BMI 较高的患者出现更多的肠外表现表明，与肥胖相关的慢性炎症可能在肠外炎症中起作用。
