Impact of Obesity on Inflammatory Bowel Disease

Khakoo, Nidah S.; Ioannou, Stephanie; Khakoo, Nabiha Shabbir; Vedantam, Shyam; Pearlman, Michelle

doi:10.1007/s11894-022-00840-x

Cited by 24 publications

(15 citation statements)

References 75 publications

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“…Since NAFLD is strongly associated with obesity, it is difficult to separate its impact from that of obesity in general on IBD outcomes. As there exists a significant body of literature on the latter association [41][42][43][44][45][46], careful assessment of any supplementary negative impact attributable to NAFLD is required. In our review, only three studies controlled for obesity in their multivariate regression model [18].…”

Section: Discussionmentioning

confidence: 99%

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Boustany

Rahhal

Mitri

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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Evidence suggests that patients with inflammatory bowel disease are at higher risk of developing nonalcoholic fatty liver disease (NAFLD). However, there is limited information currently available on how NAFLD may affect the clinical course of IBD. Thus, we conducted a systematic review to evaluate the impact of NAFLD on IBD-related hospitalization outcomes. All observational studies assessing IBD-related hospitalization outcomes in patients with NAFLD were included. Exclusion criteria were studies published in languages other than English or French, or those involving pediatric population. Outcomes included IBD-related hospitalization and readmission rates, need for surgery, length of stay, inpatient mortality, and costs. Overall, 3252 citations were retrieved and seven studies met the inclusion criteria (1 574 937 patients); all were observational, of high quality, and originated in the United States. Measurable outcomes reported in these studies were few and with insufficient similarity across studies to complete a quantitative assessment. Only one study reports NAFLD severity. Two studies suggested a higher rate of hospitalization for patients with both NAFLD and IBD compared to IBD alone (incidence rate ratio of 1.54; 95% confidence interval: 1.33–1.79). This is the first systematic review to date that evaluates any possible association of NAFLD with IBD-related hospitalization outcomes. Despite the paucity and low quality of available data, our findings indicate that NAFLD may be associated with worse outcomes amongst IBD patients (especially Crohn’s disease). Further and higher certainty of evidence is needed for better characterization of such clinical impact.

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Section: Discussionmentioning

confidence: 99%

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Boustany

Rahhal

Mitri

et al. 2023

European Journal of Gastroenterology &Amp; Hepatology

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“…This is likely due to the close monitoring by treating dietitian and adjustment of the EEN regimen by, for example, increasing formula volume or inclusion of more concentrated formula as soon as any weight loss is identified during treatment. On the other end of the nutritional scale, obesity is now considered a risk factor for worse outcomes in patients with CD 22. EEN may provide an effective weight management strategy in comparison with steroids that may further worsen nutritional status in patients who are already myopenic.…”

Section: Discussionmentioning

confidence: 99%

Lessons from an audit of exclusive enteral nutrition in adult inpatients and outpatients with active Crohn’s disease: a single-centre experience

Melton

Fitzpatrick

Taylor

et al. 2022

Frontline Gastroenterol

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ObjectiveTo evaluate clinical outcomes, patterns of use, tolerance and nutritional outcomes of exclusive enteral nutrition (EEN) in adults with Crohn’s disease and to compare initiation in the inpatient compared with ambulatory care setting.Design/methodAdults with Crohn’s disease who received EEN at a single centre over 2.5 years were identified and outcomes assessed via examination of patient records.ResultsEEN was initiated in 60 patients (23 as an outpatient) who had objective evidence of active disease. Of 49 in whom the goal was induction of remission, 28 completed EEN and 24 achieved clinical remission/response. Twenty-one withdrew prematurely, due to intolerance in 15 and disease factors in 6. Of 11 with a planned intervention, 6 fulfilled the goal of downstaging disease while two were intolerant. Completion of the prescribed therapy was associated with self-reported adherence to EEN and with improvements in disease activity scores and biochemical markers. Malnutrition halved (40% to 20%) and intentional weight loss (median 5.1 kg) was achieved in six obese patients. The major reason for intolerance was the inability to accept total avoidance of non-formula food. There were no differences in any outcomes according to the location of initiation of therapy.ConclusionPositive outcomes occur in 70% of adult patients with Crohn’s disease tolerating EEN and 81% in those who are able to completely adhere to EEN, without compromise of nutritional status. Similar success occurs when initiated as an inpatient or outpatient. Failure to tolerate EEN is the major hurdle to its use.

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“…The adipokines released from the AT can be proinflammatory in immune-mediated disorders. Visceral adiposity and obesity have an impact on several IBD-related outcomes, such as response to therapy and quality of life [ 49 ]. A survey of the existing literature also shows a link between young overweight or obese individuals and the occurrence of multiple sclerosis, which was significant for girls [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Visceral Adipose Tissue Molecular Networks and Regulatory microRNA in Pediatric Obesity: An In Silico Approach

Roy

Modi

Ghosh

et al. 2022

IJMS

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Childhood obesity carries an increased risk of metabolic complications, sleep disturbances, and cancer. Visceral adiposity is independently associated with inflammation and insulin resistance in obese children. However, the underlying pathogenic mechanisms are still unclear. We aimed to detect the gene expression pattern and its regulatory network in the visceral adipose tissue of obese pediatric individuals. Using differentially-expressed genes (DEGs) identified from two publicly available datasets, GSE9624 and GSE88837, we performed functional enrichment, protein–protein interaction, and network analyses to identify pathways, targeting transcription factors (TFs), microRNA (miRNA), and regulatory networks. There were 184 overlapping DEGs with six significant clusters and 19 candidate hub genes. Furthermore, 24 TFs targeted these hub genes. The genes were regulated by miR-16-5p, miR-124-3p, miR-103a-3p, and miR-107, the top miRNA, according to a maximum number of miRNA–mRNA interaction pairs. The miRNA were significantly enriched in several pathways, including lipid metabolism, immune response, vascular inflammation, and brain development, and were associated with prediabetes, diabetic nephropathy, depression, solid tumors, and multiple sclerosis. The genes and miRNA detected in this study involve pathways and diseases related to obesity and obesity-associated complications. The results emphasize the importance of the TGF-β signaling pathway and its regulatory molecules, the immune system, and the adipocytic apoptotic pathway in pediatric obesity. The networks associated with this condition and the molecular mechanisms through which the potential regulators contribute to pathogenesis are open to investigation.

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Impact of Obesity on Inflammatory Bowel Disease

Cited by 24 publications

References 75 publications

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

The impact of nonalcoholic fatty liver disease on inflammatory bowel disease-related hospitalization outcomes: a systematic review

Lessons from an audit of exclusive enteral nutrition in adult inpatients and outpatients with active Crohn’s disease: a single-centre experience

Visceral Adipose Tissue Molecular Networks and Regulatory microRNA in Pediatric Obesity: An In Silico Approach

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