Department of Internal Medicine, Jackson Memorial Hospital/University of Miami, Miami, FL, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Curr Gastroenterol Rep. 2022 Jan;24(1):26-36. doi: 10.1007/s11894-022-00840-x. Epub 2022 Feb 12.
This review highlights recent work that evaluates the impact of obesity on inflammatory bowel disease (IBD) pathogenesis and management.
The impact of obesity on IBD prevalence, clinical course, and management, has been studied and described more so in recent years. Studies have shown that obesity increases IBD disease activity, leads to longer hospitalization courses, and increases the likelihood of the development of extraintestinal manifestations. Recent evidence has also suggested that obese IBD patients have a higher frequency of extended steroid treatment and increased use of antibiotics compared to non-obese IBD patients. The effect of obesity on patients with IBD is a topic that has garnered widespread interest in the last decade due to the increasing prevalence of both diseases. To date however, although there are still many unanswered questions. It is quite clear that obesity, and more specifically, visceral adiposity, affects numerous IBD-related outcomes in regard to pathogenesis, extra-intestinal manifestations, response to medical and surgical therapies, hospital length of stay, healthcare-related costs, and health-related quality of life. Future studies should include larger patient populations and evaluate additional factors that are altered in those with obesity including the gut microbiome, dietary patterns, and whether weight loss and/or degree of weight loss impact clinical outcomes.
本文重点介绍了肥胖对炎症性肠病(IBD)发病机制和治疗影响的最新研究进展。
近年来,肥胖对 IBD 患病率、临床病程和治疗的影响已得到更多的研究和描述。研究表明,肥胖会增加 IBD 的疾病活动度,导致更长的住院时间,并增加发生肠外表现的可能性。最近的证据还表明,与非肥胖 IBD 患者相比,肥胖的 IBD 患者更频繁地接受延长的皮质类固醇治疗和更多地使用抗生素。由于这两种疾病的发病率都在增加,肥胖对 IBD 患者的影响在过去十年中引起了广泛关注。然而,尽管仍有许多问题尚未得到解答,但很明显,肥胖,特别是内脏肥胖,会影响到发病机制、肠外表现、对药物和手术治疗的反应、住院时间、医疗相关费用以及健康相关生活质量等多个与 IBD 相关的结局。未来的研究应包括更大的患者群体,并评估肥胖患者中改变的其他因素,包括肠道微生物组、饮食模式,以及体重减轻和/或减轻程度是否会影响临床结局。