Division of Gastroenterology and Hepatology.
Biostatistics and Informatics, Mayo Clinic, Rochester, MN.
J Clin Gastroenterol. 2024 Feb 1;58(2):176-182. doi: 10.1097/MCG.0000000000001821.
Obesity is on the rise within the inflammatory bowel disease population. The impact obesity has on the natural history of Crohn's disease (CD) is not well-understood. We aimed to describe the prevalence of obesity in a population-based cohort of newly diagnosed patients with CD, and the impact obesity had on disease phenotype and outcomes of corticosteroid use, hospitalization, intestinal resection, and development of fistulizing or penetrating disease.
A chart review was performed on Olmsted County, Minnesota residents diagnosed with CD between 1970 and 2010. Data were collected on demographics, body mass index, CD location and behavior, CD-related hospitalizations, corticosteroid use, and intestinal resection. The proportion of individuals considered obese at the time of CD diagnosis was evaluated over time, and CD-associated complications were assessed with Kaplan-Meier survival analysis.
We identified 334 individuals diagnosed with CD between 1970 and 2010, of whom 156 (46.7%) were either overweight (27.8%) or obese (18.9%) at the time of diagnosis. The proportion of patients considered obese at the time of their diagnosis of CD increased 2-3 fold over the course of the study period. However, obesity did not have a significant impact on the future risk of corticosteroid use, hospitalization, intestinal resection, or development of penetrating and stricturing complications.
Obesity is on the rise in patients with CD, although in this cohort, there did not appear to be any negative association with future CD-related outcomes. Further prospective studies, ideally including obesity measures such as visceral adipose tissue assessment, are warranted to understand the implications of the rising prevalence of obesity on CD outcomes.
炎症性肠病患者中的肥胖率正在上升。肥胖对克罗恩病（CD）自然史的影响尚不清楚。我们旨在描述新诊断的 CD 患者人群中肥胖的流行率，以及肥胖对疾病表型以及皮质类固醇使用、住院、肠道切除和瘘管或穿透性疾病发展的影响。
对明尼苏达州奥姆斯特德县 1970 年至 2010 年间诊断为 CD 的居民进行了病历回顾。收集了人口统计学、体重指数、CD 位置和行为、与 CD 相关的住院、皮质类固醇使用和肠道切除的数据。评估了在 CD 诊断时被认为肥胖的个体比例随时间的变化，并用 Kaplan-Meier 生存分析评估 CD 相关并发症。
我们确定了 1970 年至 2010 年间诊断为 CD 的 334 名个体，其中 156 名（46.7%）在诊断时超重（27.8%）或肥胖（18.9%）。在研究期间，被诊断为 CD 的患者中肥胖者的比例增加了 2-3 倍。然而，肥胖并没有对皮质类固醇使用、住院、肠道切除或穿透性和狭窄性并发症的未来风险产生显著影响。
在 CD 患者中，肥胖率正在上升，尽管在本队列中，肥胖似乎与未来 CD 相关结局没有任何负面关联。需要进一步进行前瞻性研究，理想情况下包括内脏脂肪组织评估等肥胖测量方法，以了解肥胖流行率上升对 CD 结局的影响。
