Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, China,
Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China,
Obes Facts. 2023;16(5):475-483. doi: 10.1159/000531994. Epub 2023 Aug 8.
Obesity is associated with an increased risk of inflammatory bowel disease (IBD), whereas not all obese individuals have the same effect. In individuals with obesity, the role of metabolic status in the readmission of IBD remains unclear. Our study aimed to evaluate the association between different obesity metabolic phenotypes and the prognosis of IBD patients.
We conducted a longitudinal cohort study using Nationwide Readmissions Database (NRD) (2018 sample). Out of 12,928,231 discharge records, 63,748 records with a discharge diagnosis of IBD were identified for analysis. Cox proportional hazard ratio (HR) with 95% confidence interval (CI) was calculated, adjusting for potential confounders.
During a 180-day follow-up in IBD patients with different obesity metabolic phenotypes, all-cause readmission rate, inpatient mortality rate, unplanned readmission rate, total charge, hospitalized length of stay were statistically different (all p < 0.001). After multivariate Cox regression analysis, IBD patients with metabolically unhealthy nonobese (MUNO) had higher risk of readmission (all-cause and unplanned) (HR 1.04, 95% CI: 1.00-1.08 and HR 1.06, 95% CI: 1.02-1.10), and those with metabolically unhealthy obesity (MUO) had higher risk of unplanned readmission (HR 1.08, 95% CI: 1.02-1.15). In subgroup analysis, both the MUNO group and MUO group had higher risk of readmission (all-cause and unplanned) in the ulcerative colitis (UC) subgroup, but only the MUNO group had higher risk of readmission (all-cause and unplanned) (HR 1.05, 95% CI: 1.00-1.10 and HR 1.06, 95% CI: 1.01-1.12) in the Crohn's disease (CD) subgroup.
Metabolic abnormalities were associated with an increased risk of readmission in patients with IBD, regardless of obesity.
肥胖与炎症性肠病（IBD）的风险增加有关，然而并非所有肥胖者都有相同的影响。在肥胖者中，代谢状态在 IBD 再入院中的作用尚不清楚。本研究旨在评估不同肥胖代谢表型与 IBD 患者预后之间的关系。
我们使用全国再入院数据库（NRD）（2018 年样本）进行了一项纵向队列研究。在 12928231 份出院记录中，确定了 63748 份有 IBD 出院诊断的记录进行分析。使用 Cox 比例风险比（HR）和 95%置信区间（CI）进行计算，同时调整了潜在混杂因素。
在 IBD 患者不同肥胖代谢表型的 180 天随访期间，全因再入院率、住院死亡率、非计划性再入院率、总费用和住院时间均有统计学差异（均 P < 0.001）。多变量 Cox 回归分析后，代谢不健康非肥胖（MUNO）的 IBD 患者再入院（全因和非计划性）的风险更高（HR 1.04，95%CI：1.00-1.08 和 HR 1.06，95%CI：1.02-1.10），而代谢不健康肥胖（MUO）的患者非计划性再入院的风险更高（HR 1.08，95%CI：1.02-1.15）。在亚组分析中，MUNO 组和 MUO 组在溃疡性结肠炎（UC）亚组中全因和非计划性再入院的风险更高，但只有 MUNO 组在克罗恩病（CD）亚组中全因和非计划性再入院的风险更高（HR 1.05，95%CI：1.00-1.10 和 HR 1.06，95%CI：1.01-1.12）。
代谢异常与 IBD 患者的再入院风险增加有关，无论肥胖与否。
