Impact of Obesity on Disease Activity and Patient-Reported Outcomes Measurement Information System (PROMIS) in Inflammatory Bowel Diseases

Jain, Animesh; Nguyen, Nghia; Proudfoot, James; Martin, Christopher F.; Sandborn, William J.; Kappelman, Michael D.; Long, Millie D.; Singh, Siddharth

doi:10.14309/ajg.0000000000000197

Cited by 59 publications

(45 citation statements)

References 23 publications

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“…2,18 A recent and comprehensive analysis of patient-reported data in more than 7000 IBD patients suggests increased risk of persistent disease activity or relapse in both CD and UC patients. 32 Whilst we observed no differences with regards to disease behaviour (B1-B3 in CD) and extent (E1-E3 in UC) between obese and normal weight patients in our cohort, we found that obese CD, but not UC patients, showed increased disease activity scores compared to normal weight patients. The daily soft stool frequency was increased from a median of four times per day in normal weight patients to eight times per day in obese CD patients.…”

Section: Discussioncontrasting

confidence: 79%

Impact of obesity on disease activity and disease outcome in inflammatory bowel disease: Results from the Swiss inflammatory bowel disease cohort

Greuter¹,

Porchet

Neto

et al. 2020

UEG Journal

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Objective The purpose of this study was to investigate the impact of obesity on disease activity and disease outcome in patients with inflammatory bowel disease. Patients and methods The impact of obesity on inflammatory bowel disease disease activity and outcome was retrospectively assessed in 3075 patients enrolled in the prospective nation-wide Swiss inflammatory bowel disease cohort between July 2006 and September 2018. Baseline characteristics, disease activity and disease course in 325 obese inflammatory bowel disease patients (body mass index ≥30 kg/m2) were compared to 1725 normal weight inflammatory bowel disease individuals (body mass index 18.5-24.9). Results Among 3075 patients in the prospective Swiss inflammatory bowel disease cohort, 325 patients (10.6%) were obese, namely, 194 Crohn’s disease patients, 131 ulcerative colitis, and inflammatory bowel disease-unclassified patients. Disease activity scores were elevated in obese Crohn’s disease (Crohn’s Disease Activity Index 33 vs 20, p = 0.001), but not ulcerative colitis patients. Obese Crohn’s disease, but not ulcerative colitis patients were less likely to be in remission based on a Crohn’s Disease Activity Index less than 100 and a calprotectin less than 100 ug/g. In a multivariate regression model, obesity was negatively associated with disease remission in Crohn’s disease (odds ratio 0.610, 95% confidence interval 0.402–0.926, p = 0.020), but not ulcerative colitis. Increased soft stool frequency was observed in both obese Crohn’s disease and ulcerative colitis patients. Adjusted Cox regression models revealed increased risk of complicated disease course in obese Crohn’s disease patients (hazard ratio 1.197, 95% confidence interval 1.046–1.370, p = 0.009). No association between obesity and disease progression, index treatment failure was seen neither in Crohn’s disease nor ulcerative colitis. Conclusion Obesity is associated with decreased rates of disease remission and increased risk of complicated disease course in Crohn’s disease over a six-year follow-up period. No effects were seen on disease progression and index treatment failure neither in Crohn’s disease nor ulcerative colitis.

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Section: Discussioncontrasting

confidence: 79%

Impact of obesity on disease activity and disease outcome in inflammatory bowel disease: Results from the Swiss inflammatory bowel disease cohort

Greuter¹,

Porchet

Neto

et al. 2020

UEG Journal

View full text Add to dashboard Cite

show abstract

“…Moreover, obesity might also impair clinical response to treatment, indeed in a longitudinal study in IBD patients, obesity was not only related to higher clinical activity at baseline evaluation, assessed by using validated disease activity indexes, but also to a higher risk of relapse and remaining persistently active compared with patients with normal BMI at 12 months follow-up [61]. These findings confirm previous data showing that obesity can negatively affect response to biologic therapy in patients with ulcerative colitis [62].…”

Section: Inflammatory Bowel Disease (Ibd)supporting

confidence: 85%

Role of Overweight and Obesity in Gastrointestinal Disease

et al. 2019

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The prevalence of obesity is increasing worldwide, leading to a severe impairment of overall health. Actually, obesity has been associated with several pathological conditions, causing an excess overall mortality. In particular, overweight and obesity are well known risk factors for a variety of gastrointestinal (GI) disorders i.e., functional GI disorders as well as, inflammatory bowel disease (IBD), pancreatitis, and GI cancer. The aim of the present review is to summarize the potential role of overweight and obesity in GI disease with particular focus on plausible biological mechanisms that could explain the association between obesity and GI disease based on the most recent evidence in the literature.

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“…Obesity predicts adverse clinical outcomes and treatment responses in rheumatoid arthritis, systemic lupus erythematosus and psoriasis, [88][89][90] worsens functional capacity in systemic sclerosis, 91 increases the prevalence and worsens the severity of asthma, 92 has deleterious effects in inflammatory bowel disease and multiple sclerosis, 93,94 and contributes to the progression of diabetes, non-alcoholic steatohepatitis and chronic kidney disease. [95][96][97] By acting as a broad accelerant of systemic inflammation, obesity potentiates the likelihood of heart failure (particularly HFpEF) in patients who are already prone to its development.…”

Section: Obesity As a Link Between Systemic Inflammation And Metabolimentioning

confidence: 99%

Characterization of the inflammatory‐metabolic phenotype of heart failure with a preserved ejection fraction: a hypothesis to explain influence of sex on the evolution and potential treatment of the disease

Packer

Lam

Lund

et al. 2020

European J of Heart Fail

117

109

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Accumulating evidence points to the existence of an inflammatory-metabolic phenotype of heart failure with a preserved ejection fraction (HFpEF), which is characterized by biomarkers of inflammation, an expanded epicardial adipose tissue mass, microvascular endothelial dysfunction, normal-to-mildly increased left ventricular volumes and systolic blood pressures, and possibly, altered activity of adipocyte-associated inflammatory mediators. A broad range of adipogenic metabolic and systemic inflammatory disorders-e.g. obesity, diabetes and metabolic syndrome as well as rheumatoid arthritis and psoriasis-can cause this phenotype, independent of the presence of large vessel coronary artery disease. Interestingly, when compared with men, women are both at greater risk of and may suffer greater cardiac consequences from these systemic inflammatory and metabolic disorders. Women show disproportionate increases in left ventricular filling pressures following increases in central blood volume and have greater arterial stiffness than men. Additionally, they are particularly predisposed to epicardial and intramyocardial fat expansion and imbalances in adipocyte-associated proinflammatory mediators. The hormonal interrelationships seen in inflammatory-metabolic phenotype may explain why mineralocorticoid receptor antagonists and neprilysin inhibitors may be more effective in women than in men with HFpEF. Recognition of the inflammatory-metabolic phenotype may improve an understanding of the pathogenesis of HFpEF and enhance the ability to design clinical trials of interventions in this heterogeneous syndrome.

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Impact of Obesity on Disease Activity and Patient-Reported Outcomes Measurement Information System (PROMIS) in Inflammatory Bowel Diseases

Cited by 59 publications

References 23 publications

Impact of obesity on disease activity and disease outcome in inflammatory bowel disease: Results from the Swiss inflammatory bowel disease cohort

Impact of obesity on disease activity and disease outcome in inflammatory bowel disease: Results from the Swiss inflammatory bowel disease cohort

Role of Overweight and Obesity in Gastrointestinal Disease

Characterization of the inflammatory‐metabolic phenotype of heart failure with a preserved ejection fraction: a hypothesis to explain influence of sex on the evolution and potential treatment of the disease

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