Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-Dong, Bundang-Gu, Seongnam, Gyeonggi-Do, 463-707, South Korea.
Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
BMC Gastroenterol. 2023 Nov 21;23(1):405. doi: 10.1186/s12876-023-03008-7.
Many patients with ulcerative colitis (UC) gain weight after treatment. However, the clinical significance of weight gain in these patients remains unclear. This study aimed to evaluate body weight changes after treatment in patients newly diagnosed with moderate-to-severe UC and their effects on patients' prognosis.
The change in weight between diagnosis and 1 year after treatment in 212 patients enrolled in the MOSAIK cohort (mean age, 40 years; males, 60%) was analyzed. Significant weight gain was defined as a weight increase of ≥ 5% from the baseline at 1 year. Factors associated with significant weight gain and the effect of significant weight gain on the risk of major adverse outcomes (clinical relapse, hospitalization, and new use of steroids or biologics) during a follow-up period of 20 months were evaluated.
Mean weight gain at 1 year was 1.7 ± 4.2 kg. The proportion of overweight/obese patients increased by 9.0% from 37.9% to 46.9%. Thirty-two percent had significant weight gain; extensive colitis at diagnosis was the only factor associated with significant weight gain (odds ratio 6.5, 95% confidence interval 1.4-31.0, p = 0.006). In multivariable analysis, significant weight gain was not associated with the risk of major adverse outcomes. Weight loss symptoms at diagnosis were associated with an increased risk for new steroid use after 1 year.
Approximately one-third of patients with moderate-to-severe UC had significant weight gain after 1 year of treatment. However, significant weight gain was not associated with the patient's prognosis.
许多溃疡性结肠炎(UC)患者在治疗后体重增加。然而,这些患者体重增加的临床意义尚不清楚。本研究旨在评估新诊断为中重度 UC 的患者治疗后体重变化及其对患者预后的影响。
对 MOSAIK 队列中 212 例患者(平均年龄 40 岁;男性占 60%)在诊断和治疗后 1 年之间体重的变化进行分析。显著体重增加定义为治疗 1 年后体重比基线增加≥5%。分析与显著体重增加相关的因素,以及显著体重增加对 20 个月随访期间主要不良结局(临床复发、住院和新使用类固醇或生物制剂)风险的影响。
治疗 1 年后平均体重增加 1.7±4.2kg。超重/肥胖患者的比例从 37.9%增加到 46.9%,增加了 9.0%。32%的患者体重显著增加;诊断时广泛性结肠炎是唯一与显著体重增加相关的因素(比值比 6.5,95%置信区间 1.4-31.0,p=0.006)。多变量分析显示,显著体重增加与主要不良结局的风险无关。诊断时的体重减轻症状与治疗 1 年后新使用类固醇有关。
大约三分之一的中重度 UC 患者在治疗 1 年后体重显著增加。然而,显著的体重增加与患者的预后无关。