50岁以下成年人中重度肥胖率的上升与非恶性胃肠疾病住院人数的增加相对应。

Rising Rates of Severe Obesity in Adults Younger Than 50 Correspond to Rise in Hospitalizations for Non-malignant Gastrointestinal Disease.

作者信息

Patel Arsheya, Krishna Somashekar G, Patel Kishan, Gray Darrell M, Mumtaz Khalid, Stanich Peter P, Hinton Alice, Hussan Hisham

机构信息

Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Ohio State University, 395 W 12th Ave, Suite 240, Columbus, OH, 43210, USA.

The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.

出版信息

Dig Dis Sci. 2023 Feb;68(2):554-563. doi: 10.1007/s10620-022-07589-3. Epub 2022 Jun 15.

DOI:10.1007/s10620-022-07589-3

PMID:35704253

Abstract

BACKGROUND

Colorectal cancer incidence is rising in adults < 50 years old, possibly due to obesity. Non-malignant colorectal conditions are understudied in this population. We hypothesize that developing severe obesity in young adulthood also corresponds with increased hospitalization rates for non-malignant colorectal conditions.

METHODS

We examined annual percent change (APC) in the prevalence of obesity in adults < 50 using the 2009-2014 National Health and Nutrition Examination Survey. Using the 2010-2014 Nationwide Readmission Database, we then compared yearly hospitalization trends for various gastrointestinal conditions and their outcomes in adults < 50 with severe obesity vs. no obesity.

RESULTS

The prevalence of obesity increased in adults < 50 years in 2009-2014. This increase was most pronounced for severe obesity (APC of + 12.8%). The rate of patients with severe obesity < 50 who were admitted for gastrointestinal diseases has increased by 7.76% per year in 2010-2014 (p < 0.001). This increase was > 10% per year for colorectal conditions such Clostridium difficile infections (APC + 17.3%, p = 0.002), inflammatory bowel disease (APC + 13.1%, p = 0.001), and diverticulitis (APC + 12.7%, p = 0.002). The hospitalization rate for chronic liver diseases and acute pancreatitis also increased by 12.2% and 10.0% per year, respectively (p < 0.01). In contrast, young adults without obesity had lower hospitalization rate for most gastrointestinal diseases. Furthermore, adults with no obesity had lower mortality rates for appendicitis, diverticulitis, pancreatitis and chronic liver diseases than adults with severe obesity.

CONCLUSION

Our data suggest that increased adiposity in young adults is associated with more hospitalization and worse outcomes for infectious/inflammatory gastrointestinal conditions. Future prevention strategies are warranted to ameliorate these trends.

摘要

背景

50岁以下成年人的结直肠癌发病率正在上升，可能与肥胖有关。该人群中结直肠非恶性疾病的研究较少。我们假设，青年时期出现重度肥胖也与结直肠非恶性疾病的住院率增加有关。

方法

我们使用2009 - 2014年国家健康与营养检查调查，研究了50岁以下成年人肥胖患病率的年度变化百分比（APC）。然后，利用2010 - 2014年全国再入院数据库，比较了50岁以下重度肥胖与非肥胖成年人各种胃肠道疾病的年度住院趋势及其结果。

结果

2009 - 2014年，50岁以下成年人的肥胖患病率有所增加。这种增加在重度肥胖人群中最为明显（APC为 + 12.8%）。2010 - 2014年，50岁以下因胃肠道疾病入院的重度肥胖患者比例每年增加7.76%（p < 0.001）。对于诸如艰难梭菌感染（APC + 17.3%，p = 0.002）、炎症性肠病（APC + 13.1%，p = 0.001）和憩室炎（APC + 12.7%，p = 0.002）等结直肠疾病，这一增加幅度每年超过10%。慢性肝病和急性胰腺炎的住院率也分别每年增加12.2%和10.0%（p < 0.01）。相比之下，非肥胖的年轻人大多数胃肠道疾病的住院率较低。此外，非肥胖成年人阑尾炎、憩室炎、胰腺炎和慢性肝病的死亡率低于重度肥胖成年人。