Isfahan Medical Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Neurogastroenterol Motil. 2019 Apr;31(4):e13549. doi: 10.1111/nmo.13549. Epub 2019 Jan 18.
Earlier studies on the obesity-IBS association have mostly been reported from Western nations, and limited data are available in this regard from developing countries. This study was performed to examine the association of general and abdominal obesity with Irritable bowel syndrome (IBS) in a Middle Eastern population.
In this cross-sectional study, 4763 Iranian adults participated. Data on self-reported anthropometric measurements were collected, and BMI was calculated. Overweight and obesity were defined as 25 ≤ BMI < 30 and BMI ≥ 30 kg/m , respectively. Also, we used WC measurements to define the three categories of normal (<94 cm in men <80 cm in women), abdominal overweight (94 ≤ WC < 102 in men and 80 ≤ WC < 88 in women), and abdominal obesity (WC ≥ 102 cm in men and WC ≥ 88 cm in women). Assessment of different GI symptoms including those related to IBS was done using a validated Persian version of the Rome III questionnaire. IBS was defined as the presence of recurrent abdominal pain or discomfort at least sometimes in the last 3 months associated with 2 or more of the following features: improvement with defecation, pain onset associated with a change in frequency of stool, and pain onset associated with a change in form (appearance) of stool.
Irritable bowel syndrome was more prevalent among individuals with abdominal obesity compared with normal subjects (23.8% vs 19%). Neither in crude nor in adjusted models, we found any significant association between overweight and obesity and IBS [for overweight: OR: 0.95, 95% CI: 0.66-1.36 and for obesity: OR: 1.06, 95% CI: 0.85-1.31]. We observed a significant positive association between abdominally overweight and IBS in crude model (OR: 1.31, 95% CI: 1.09-1.60); however, this association became non-significant after adjustment for potential confounders (OR: 1.09, 95% CI: 0.82-1.44). Across BMI categories, neither in crude nor in adjusted models, we did not find any significant association between overweight (OR: 0.89, 95% CI: 0.62-1.27), obesity (OR: 1.05, 95% CI: 0.58-1.87), and abdominal pain severity. Abdominal overweight (OR: 0.96, 95% CI: 0.65-1.40) and obesity (OR: 1.61, 95% CI: 0.67-1.63) were not associated with abdominal pain severity.
It is concluded that general or abdominal obesity was not associated with odds of IBS. Future longitudinal studies are needed to clarify the association between obesity and IBS.
之前关于肥胖与肠易激综合征（IBS）关联的研究主要来自西方国家，而发展中国家这方面的数据有限。本研究旨在检查中东人群中一般肥胖和腹部肥胖与肠易激综合征（IBS）的关联。
在这项横断面研究中，共有 4763 名伊朗成年人参与。收集了自我报告的人体测量学测量数据，并计算了 BMI。超重和肥胖的定义分别为 25≤BMI<30 和 BMI≥30kg/m2。此外，我们使用 WC 测量值来定义正常（男性<94cm，女性<80cm）、腹部超重（男性 94≤WC<102cm，女性 80≤WC<88cm）和腹部肥胖（男性 WC≥102cm，女性 WC≥88cm）三个类别。使用经过验证的罗马 III 问卷的波斯语版本评估了不同的胃肠道症状，包括与 IBS 相关的症状。IBS 的定义为在过去 3 个月中至少有时反复发作腹痛或不适，伴有以下 2 种或更多特征：排便后缓解、排便频率改变时疼痛开始、粪便形状（外观）改变时疼痛开始。
与正常人群相比，腹部肥胖人群中 IBS 更为常见（23.8% vs 19%）。在未调整和调整模型中，我们均未发现超重和肥胖与 IBS 之间存在任何显著关联[超重：OR：0.95，95%CI：0.66-1.36；肥胖：OR：1.06，95%CI：0.85-1.31]。在未调整模型中，我们观察到腹部超重与 IBS 之间存在显著的正相关（OR：1.31，95%CI：1.09-1.60）；然而，在调整潜在混杂因素后，这种关联变得不显著（OR：1.09，95%CI：0.82-1.44）。在 BMI 类别中，我们在未调整和调整模型中均未发现超重（OR：0.89，95%CI：0.62-1.27）、肥胖（OR：1.05，95%CI：0.58-1.87）和腹痛严重程度之间存在任何显著关联。腹部超重（OR：0.96，95%CI：0.65-1.40）和肥胖（OR：1.61，95%CI：0.67-1.63）与腹痛严重程度无关。
综上所述，一般肥胖或腹部肥胖与 IBS 的几率无关。需要进一步的纵向研究来阐明肥胖与 IBS 之间的关系。
