Bhagavathula Akshaya Srikanth, Clark Cain C T, Rahmani Jamal, Chattu Vijay Kumar
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Univerziti Kralova, 500 03 Hradec Kralova, Czech Republic.
Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK.
Healthcare (Basel). 2021 Jan 3;9(1):35. doi: 10.3390/healthcare9010035.
A growing trove of literature describes the effect of malnutrition and underweight on the incidence of inflammatory bowel disease (IBD). However, evidence regarding the association between underweight or obesity and IBD is limited. The study aimed to assess the association of body mass index (BMI) with a risk of IBD (Crohn's disease (CD) and ulcerative colitis (U.C.)) incidence.
We systematically searched PubMed/Medline, Cochrane, Web of Science, and Scopus for observational studies assessing the association between BMI and IBD that were published up to 30 June 2020. We estimated pooled hazard ratios (HR) with corresponding 95% confidence intervals (CI). Random effect dose-response meta-analysis was performed using the variance weighted least-squares regression (VWLS) models to identify non-linear associations.
A total of ten studies involving 15.6 million individuals and 23,371 cases of IBD were included. Overall, obesity was associated with an increased IBD risk (HR: 1.20, 95% CI: 1.08-1.34, = 0%). Compared to normal weight, underweight (BMI < 18.5 kg/m) and obesity (BMI ≥ 30 kg/m) were associated with a higher risk of CD, and there was no difference in the risk of U.C. among those with BMI < 18.5 kg/m and BMI ≥ 30 kg/m. There was a significant non-linear association between being underweight and obesity and the risk of development of CD (Coef = -0.0902, < 0.001 Coef = 0.0713, < 0.001).
Obesity increases the risk of IBD development. Underweight and obesity are independently associated with an increased risk of CD, yet there is no evident association between BMI and the risk of U.C. Further studies are needed to clarify the underlying mechanism for these findings, particularly in CD.
越来越多的文献描述了营养不良和体重不足对炎症性肠病（IBD）发病率的影响。然而，关于体重不足或肥胖与IBD之间关联的证据有限。本研究旨在评估体重指数（BMI）与IBD（克罗恩病（CD）和溃疡性结肠炎（U.C.））发病风险之间的关联。
我们系统检索了PubMed/Medline、Cochrane、科学网和Scopus，以查找截至2020年6月30日发表的评估BMI与IBD之间关联的观察性研究。我们估计了合并风险比（HR）及相应的95%置信区间（CI）。使用方差加权最小二乘回归（VWLS）模型进行随机效应剂量反应荟萃分析，以识别非线性关联。
共纳入10项研究，涉及1560万人和23371例IBD病例。总体而言，肥胖与IBD风险增加相关（HR：1.20，95%CI：1.08 - 1.34，P = 0%）。与正常体重相比，体重不足（BMI < 18.5 kg/m²）和肥胖（BMI≥30 kg/m²）与CD风险较高相关，BMI < 18.5 kg/m²和BMI≥30 kg/m²者的U.C.风险无差异。体重不足和肥胖与CD发病风险之间存在显著的非线性关联（系数 = -0.0902，P < 0.001；系数 = 0.0713，P < 0.001）。
肥胖会增加IBD发病风险。体重不足和肥胖与CD风险增加独立相关，但BMI与U.C.风险之间无明显关联。需要进一步研究来阐明这些发现的潜在机制，尤其是在CD方面。
