Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.
Am J Gastroenterol. 2019 Apr;114(4):630-639. doi: 10.14309/ajg.0000000000000197.
We conducted a cohort study on the impact of obesity on disease activity and Patient-Reported Outcomes Measurement Information System (PROMIS) measures in the inflammatory bowel disease (IBD) Partners cohort.
We performed a cross-sectional and longitudinal study within IBD Partners, an internet-based cohort of >15,000 patients living with Crohn's disease (CD) and ulcerative colitis (UC). We included adult patients with IBD, with recorded body mass index (BMI), with at least 6 months of follow-up, excluding patients with BMI < 18.5 kg/m. We evaluated the independent effect of World Health Organization classes of obesity on risk of clinical relapse or persistent disease activity (using validated disease activity indexes) and PROMIS measures, using multivariate logistic regression and linear regression, respectively.
We included 7,296 patients with IBD (4,748 patients with CD, 19.5% obese; 2,548 patients with UC with intact colon, 20.3% obese). Obesity was independently, and in a dose-dependent fashion, associated with an increased risk of persistent disease activity or relapse in both patients with CD (class II or III obesity vs normal BMI: adjusted odds ratio, 1.86; 95% confidence interval, 1.30-2.68) and UC (adjusted odds ratio, 2.97; 95% confidence interval, 1.75-5.17). Obesity was also independently associated with higher anxiety, depression, fatigue, pain, and inferior social function scores in patients with CD and UC at baseline and with worsening depression, fatigue, pain, and social function in patients with CD on longitudinal assessment.
Obesity at baseline is independently associated with worsening disease activity and PROMIS measures in patients with IBD.
我们在炎症性肠病（IBD）伙伴队列中进行了一项队列研究，以评估肥胖对疾病活动度和患者报告的结局测量信息系统（PROMIS）测量指标的影响。
我们在 IBD 伙伴中进行了一项横断面和纵向研究，该研究是一个基于互联网的超过 15000 名患有克罗恩病（CD）和溃疡性结肠炎（UC）的患者的队列。我们纳入了有记录体重指数（BMI）的 IBD 成年患者，且至少有 6 个月的随访期，BMI<18.5kg/m 的患者除外。我们使用多变量逻辑回归和线性回归分别评估了世界卫生组织肥胖类别对临床复发或持续性疾病活动（使用验证后的疾病活动指数）和 PROMIS 测量指标的独立影响。
我们纳入了 7296 名 IBD 患者（4748 名 CD 患者，19.5%肥胖；2548 名 UC 患者，结肠完整，20.3%肥胖）。肥胖与 CD 患者持续性疾病活动或复发的风险呈独立且剂量依赖性增加相关（II 类或 III 类肥胖与正常 BMI 相比：调整后的优势比，1.86；95%置信区间，1.30-2.68）和 UC（调整后的优势比，2.97；95%置信区间，1.75-5.17）。肥胖还与 CD 和 UC 患者的基线时更高的焦虑、抑郁、疲劳、疼痛和较差的社会功能评分相关，且与 CD 患者纵向评估时的抑郁、疲劳、疼痛和社会功能恶化相关。
基线肥胖与 IBD 患者的疾病活动度和 PROMIS 测量指标恶化独立相关。
