Sehgal Priya, Shen Bo, Li Jianhua, Freedberg Daniel E
Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, New York, USA.
Division of Colorectal Surgery, Columbia University Irving Medical Center, New York, New York, USA.
Frontline Gastroenterol. 2022 Dec 23;14(4):319-325. doi: 10.1136/flgastro-2022-102276. eCollection 2023.
Obesity is a potentially modifiable risk factor for inflammatory bowel disease (IBD). We aimed to evaluate the body mass index (BMI) of those diagnosed with IBD early versus late in life in the context of age-adjusted background population.
DESIGN/METHOD: Patients with a new diagnosis of IBD from 2000 to 2021 were included. Early-onset IBD was classified as age <18 and late-onset IBD classified as age ≥65. Obesity was classified as BMI ≥30 kg/m. Population data were obtained from community surveys.
Included were 1573 patients (56.0%) with Crohn's disease (CD) and 1234 (44.0%) with ulcerative colitis (UC). Overall, the median BMI at IBD diagnosis was 20 kg/m (IQR 18-24) among those diagnosed at age <18 vs 26.9 kg/m (IQR 23.1-30.0) among those diagnosed at age ≥65 (rank-sum p<0.01). In all age groups, BMI was stable during the 1-year preceding IBD diagnosis. At age <18, 11.5% of the background population was obese compared with 3.8% of those with newly diagnosed CD (p<0.01) and 4.8% of those with newly diagnosed UC (p=0.05). At age ≥65, 23.6% of the population was obese compared with 24.3% of those with newly diagnosed CD (p=0.78) and 29.5% of those with newly diagnosed UC (p=0.01).
Patients with IBD diagnosed at age <18 were less likely to be obese compared with the age-adjusted background population whereas those diagnosed at age ≥65 were more likely to be obese. Future prospective studies should investigate obesity as a modifiable risk factor for late-life IBD.
肥胖是炎症性肠病(IBD)一个潜在可改变的风险因素。我们旨在在年龄调整背景人群的背景下,评估在生命早期与晚期被诊断为IBD者的体重指数(BMI)。
设计/方法:纳入2000年至2021年新诊断为IBD的患者。早发型IBD被分类为年龄<18岁,晚发型IBD被分类为年龄≥65岁。肥胖被分类为BMI≥30kg/m²。人群数据来自社区调查。
纳入1573例克罗恩病(CD)患者(56.0%)和1234例溃疡性结肠炎(UC)患者(44.0%)。总体而言,<18岁时被诊断为IBD者在IBD诊断时的BMI中位数为20kg/m²(四分位间距18 - 24),而≥65岁时被诊断为IBD者为26.9kg/m²(四分位间距23.1 - 30.0)(秩和检验p<0.01)。在所有年龄组中,BMI在IBD诊断前1年保持稳定。<18岁时,背景人群中11.5%肥胖,而新诊断为CD者中为3.8%(p<0.01),新诊断为UC者中为4.8%(p = 0.05)。≥65岁时,人群中23.6%肥胖,而新诊断为CD者中为24.3%(p = 0.78),新诊断为UC者中为29.5%(p = 0.01)。
与年龄调整背景人群相比,<18岁被诊断为IBD的患者肥胖可能性较小,而≥65岁被诊断为IBD的患者肥胖可能性较大。未来前瞻性研究应调查肥胖作为晚年IBD一个可改变风险因素的情况。