肿瘤坏死因子拮抗剂联合治疗及抗整合素疗法对炎症性肠病患者体重指数的影响：一项横断面研究
Impact of tumor necrosis factor antagonist combination and anti-integrin therapies on body mass index in inflammatory bowel disease: A cross-sectional study.
作者信息
Shehab Mohammad, Alali Ali, Al-Hindawi Ahmed, Alsayegh Abdulwahab, Aldallal Usama, Abdullah Israa, Albaghli Abbas, Alrashed Fatema, Alfadhli Ahmad, Bessissow Talat
机构信息
Department of Internal Medicine, Faculty of Medicine, Mubarak Al-Kabeer Hospital, Kuwait University, Jabriya, Kuwait.
School of Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Al Muharraq, Bahrain.
出版信息
Front Med (Lausanne). 2023 Jan 6;9:1045661. doi: 10.3389/fmed.2022.1045661. eCollection 2022.
BACKGROUND
The impact of biologic therapies on body mass index (BMI) in patients with inflammatory bowel disease (IBD) is unclear. This study investigates any associations between BMI, type of IBD, and the type of medications taken among patients with IBD with varying weight categories.
METHODS
A cross sectional study was performed in an IBD tertiary care center. Data was obtained from patients with IBD attending outpatient clinics from January 1st, 2021 until November 1st, 2021. Adult patients, older than 18 years, with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were recruited. The primary outcome was the association between BMI and medication used in IBD. The secondary outcome was the association between BMI and disease type and location in patients with IBD.
RESULTS
The study included a total of 528 patients of which, 66.5% have CD. Patients with normal weight comprises 55.9% of the participants, while those who are underweight, overweight or obese are 3.4, 28.2, and 12.5%, respectively. None of the underweight patients had UC. Among the normal weight, overweight and obese BMI categories, 34.6% vs. 36.2% vs. 31.8% had UC, respectively. Patients who are on tumor necrosis factor inhibitors (anti-TNF) with an immunomodulator (anti-TNF combination), are more likely to be overweight or obese than patients who are not on anti-TNF combination (OR 2.86, 95% CI 1.739-4.711, < 0.001). Patients on vedolizumab are twice as likely to be overweight or obese than patients not on vedolizumab (OR 2.23, 95% CI 1.086-4.584, < 0.05). Patients with ileocolonic CD are more likely to be overweight or obese compared to other subtypes of CD (OR 1.78, 95% CI 1.14-2.77, = 0.01).
CONCLUSION
Many patients with IBD are either obese or overweight. Patients with IBD who are on anti-TNF combination therapy or vedolizumab monotherapy are more likely to be obese and overweight. In addition, patients will ileocolonic CD are more likely to be obese or overweight.
背景
生物疗法对炎症性肠病（IBD）患者体重指数（BMI）的影响尚不清楚。本研究调查了不同体重类别的IBD患者中BMI、IBD类型和所用药物类型之间的关联。
方法
在一家IBD三级护理中心进行了一项横断面研究。数据来自2021年1月1日至2021年11月1日在门诊就诊的IBD患者。招募年龄超过18岁、诊断为克罗恩病（CD）或溃疡性结肠炎（UC）的成年患者。主要结局是IBD中BMI与所用药物之间的关联。次要结局是IBD患者中BMI与疾病类型和部位之间的关联。
结果
该研究共纳入528例患者，其中66.5%患有CD。体重正常的患者占参与者的55.9%，而体重过轻、超重或肥胖的患者分别占3.4%、28.2%和12.5%。体重过轻的患者中无一例患有UC。在体重正常、超重和肥胖的BMI类别中，分别有34.6%、36.2%和31.8%患有UC。与未接受抗TNF联合治疗的患者相比，接受肿瘤坏死因子抑制剂（抗TNF）联合免疫调节剂（抗TNF联合治疗）的患者更有可能超重或肥胖（比值比2.86，95%置信区间1.739 - 4.711，P < 0.001）。接受维多珠单抗治疗的患者超重或肥胖的可能性是未接受维多珠单抗治疗患者的两倍（比值比2.23，95%置信区间1.086 - 4.584，P < 0.05）。与CD的其他亚型相比，回结肠型CD患者更有可能超重或肥胖（比值比1.78，95%置信区间1.14 - 2.77，P = 0.01）。
结论
许多IBD患者要么肥胖要么超重。接受抗TNF联合治疗或维多珠单抗单药治疗的IBD患者更有可能肥胖和超重。此外，患有回结肠型CD的患者更有可能肥胖或超重。
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