Prospective study of body mass index and risk of sarcoidosis in US women

Dumas, Orianne; Boggs, Krislyn M.; Cozier, Yvette C.; Stampfer, Meir J.; Camargo, Carlos A.

doi:10.1183/13993003.01397-2017

Cited by 30 publications

(29 citation statements)

References 14 publications

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“…Data from the Black Women's Health Study and the Nurses' Health Study II show that weight gain and obesity during adulthood are associated with higher sarcoidosis incidence [2] and that higher BMI is prospectively associated with an increased risk of developing sarcoidosis. [3] Obesity can be both a consequence of and a risk factor for the development of sarcoidosis since the corticosteroid therapy used to manage the disease leads to weight gain. Additionally, obesity creates a proinflammatory state [5] which may contribute to sarcoidosis pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Obesity is an independent risk factor for sarcoidosis incidence and progression. [2][3][4] Sarcoidosis treatment often involves corticosteroids which can lead to weight gain, making weight management particularly challenging for sarcoidosis patients. Obesity can be both a consequence of sarcoidosis treatment and a contributor to disease risk likely through the pro-inflammatory environment of obesity.…”

Section: Introductionmentioning

confidence: 99%

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Improvement of pulmonary sarcoidosis following sleeve gastrectomy

Hassell¹,

Grzeszczak²,

Adams³

et al. 2019

CRIM

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Pulmonary sarcoidosis is unlikely to resolve if it persists for greater than five years. A growing body of literature supports the involvement of the microbiome in sarcoidosis and a role for sex hormones in pulmonary fibrosis. Additionally, obesity is a risk factor for the development of sarcoidosis. Bariatric surgery is an effective treatment for obesity and can lead to microbial and endocrine changes. Here, we report the clinical improvement of longstanding pulmonary sarcoidosis following sleeve gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improvement of pulmonary sarcoidosis following sleeve gastrectomy

Hassell¹,

Grzeszczak²,

Adams³

et al. 2019

CRIM

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“…It is not clear whether these associations are a result of sarcoidosis itself, corticosteroid use, or confounding variables. Obesity may be a risk factor for sarcoidosis, rather than a result of sarcoidosis 139. Nonetheless, data now support the hypothesis that a high proportion of comorbidities in sarcoidosis populations are a consequence of corticosteroid therapy 135.…”

Section: Treatment Optionsmentioning

confidence: 96%

“…Epidemiologic data have revealed an unexpectedly high rate of comorbid disease in sarcoidosis populations, including obesity, hypertension, diabetes, hypercholesterolemia, and osteoporosis 127137138139. It is not clear whether these associations are a result of sarcoidosis itself, corticosteroid use, or confounding variables.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Recent evidence also suggests that granuloma formation is augmented by the mammalian target of rapamycin (mTOR) pathway, in both a murine model and by assessment of gene expression in human sarcoidosis patients 218219. The mTOR pathway is a critically central integrator of multiple exogenous and endogenous signals that serves to control cell proliferation and responses220; variation in mTOR signaling could partly explain some clinical observations about sarcoidosis risk such as the female preponderance and the higher rate of disease in obese patients 8139. It is unlikely that constitutive mTOR activation is sufficient to cause sarcoidosis in the absence of specific antigenic triggers, but more investigation is needed to elucidate this point.…”

Section: Therapeutic Implications Of Pathogenesismentioning

confidence: 99%

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New advances in the management of pulmonary sarcoidosis

Culver

Judson

2019

BMJ

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Sarcoidosis is a highly variable granulomatous multisystem syndrome. It affects individuals in the prime years of life; both the frequency and severity of sarcoidosis are greater in economically disadvantaged populations. The diagnosis, assessment, and management of pulmonary sarcoidosis have evolved as new technologies and therapies have been adopted. Transbronchial needle aspiration guided by endobronchial ultrasound has replaced mediastinoscopy in many centers. Advanced imaging modalities, such as fluorodeoxyglucose positron emission tomography scanning, and the widespread availability of magnetic resonance imaging have led to more sensitive assessment of organ involvement and disease activity. Although several new insights about the pathogenesis of sarcoidosis exist, no new therapies have been specifically developed for use in the disease. The current or proposed use of immunosuppressive medications for sarcoidosis has been extrapolated from other disease states; various novel pathways are currently under investigation as therapeutic targets. Coupled with the growing recognition of corticosteroid toxicities for managing sarcoidosis, the use of corticosteroid sparing anti-sarcoidosis medications is likely to increase. Besides treatment of granulomatous inflammation, recognition and management of the non-granulomatous complications of pulmonary sarcoidosis are needed for optimal outcomes in patients with advanced disease.

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