Department of Internal Medicine, Saint Louis University, St Louis, MO, USA.
Division of Gastroenterology & Hepatology, Department of Internal Medicine, Saint Louis University, St. Louis, MO, USA.
Dig Dis Sci. 2024 Aug;69(8):2741-2753. doi: 10.1007/s10620-024-08504-8. Epub 2024 Jun 12.
The recent surge in inflammatory bowel disease (IBD) cases has paralleled a significant rise in obesity and metabolic comorbidities rates. In this article, we explore the potential influence of obesity and associated metabolic comorbidities on disease progression, complications, treatment response, surgical outcomes, health economics, and the potential impact of obesity treatment on the course of IBD.
Contrary to visceral adiposity, obesity does not consistently result in an increased risk of IBD-related complications. Patients with IBD have a higher risk of acute arterial events, likely linked to systemic inflammation. Substantial evidence suggests that obesity has a negative impact on the response to IBD treatment, with this effect being most thoroughly studied in biologics and immunomodulators. The rates of overall complications and post-operative infections are higher in patients who are obese. There are limited but promising data regarding the impact of weight loss techniques, including exercise, medications, and bariatric interventions, on the outcomes in IBD. Both obesity and diabetes have adverse effects on the overall quality of life and place an increased financial burden on the IBD population. A growing body of evidence indicates a connection between obesity and associated metabolic comorbidities and negative outcomes in IBD, yet further efforts are required to fully understand this relationship.
炎症性肠病（IBD）病例的近期激增与肥胖和代谢合并症的发生率显著上升并行不悖。本文探讨了肥胖症和相关代谢合并症对疾病进展、并发症、治疗反应、手术结果、健康经济学的潜在影响，以及肥胖症治疗对 IBD 病程的潜在影响。
与内脏肥胖不同，肥胖症并不一定会导致 IBD 相关并发症的风险增加。IBD 患者发生急性动脉事件的风险较高，可能与全身炎症有关。大量证据表明，肥胖症对 IBD 治疗反应有负面影响，这在生物制剂和免疫调节剂中的研究最为透彻。肥胖患者的总体并发症和术后感染发生率更高。关于减肥技术（包括运动、药物和减重干预）对 IBD 结局的影响，数据有限但有希望。肥胖症和糖尿病均对整体生活质量产生不良影响，并给 IBD 人群带来更大的经济负担。越来越多的证据表明，肥胖症和相关代谢合并症与 IBD 的不良结局之间存在关联，但仍需要进一步努力以充分了解这种关系。
