Visceral Adipose Tissue Is Associated With Stricturing Crohn’s Disease Behavior, Fecal Calprotectin, and Quality of Life

Bryant, Robert V.; Schultz, Christopher G.; Ooi, Soong-Yuan J.; Goess, Charlotte; Costello, Samuel P; Vincent, Andrew; Schoeman, Scott; Lim, Amanda; Bartholomeusz, Francis Dylan; Travis, Simon; Andrews, Jane M.

doi:10.1093/ibd/izy278

Cited by 49 publications

(32 citation statements)

References 26 publications

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“…Studies in patients with CD disease using visceral adiposity as a measure of obesity have more consistently shown the increased risk of CD-related complications than those using BMI as a marker of overall obesity [58][59][60][61][62][63][64]. Erhayiem et al [58], in a study on 97 patients with CD, found that using computed tomography (CT) scanning that mesenteric fat index (MFI), defined as the ratio of areas of visceral-to-subcutaneous fat was a good marker of aggressive CD.…”

Section: Effect Of Obesity On the Course Of Ibdmentioning

confidence: 99%

“…These observations were confirmed in study by Li et al [59] also using CT scanning method; they found that visceral fat area and MFI values were associated with postoperative recurrence of Crohn's disease. Bryant et al [60], in a prospective study on 97 patients with CD, used dual energy X-ray absorptiometry (DXA) as a method to assess VAT. They also reported that VAT/subcutaneous adipose tissue [SAT] ratio, rather than BMI, was associated with structuring CD behaviour, an increase in disease activity, and reduced QoL.…”

Section: Effect Of Obesity On the Course Of Ibdmentioning

confidence: 99%

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Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

et al. 2019

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Inflammatory bowel diseases (IBDs) are a group of disorders which include ulcerative colitis and Crohn’s disease. Obesity is becoming increasingly more common among patients with inflammatory bowel disease and plays a role in the development and course of the disease. This is especially true in the case of Crohn’s disease. The recent results indicate a special role of visceral adipose tissue and particularly mesenteric adipose tissue, also known as “creeping fat”, in pathomechanism, leading to intestinal inflammation. The involvement of altered adipocyte function and the deregulated production of adipokines, such as leptin and adiponectin, has been suggested in pathogenesis of IBD. In this review, we discuss the epidemiology and pathophysiology of obesity in IBD, the influence of a Western diet on the course of Crohn’s disease and colitis in IBD patients and animal’s models, and the potential role of adipokines in these disorders. Since altered body composition, decrease of skeletal muscle mass, and development of pathologically changed mesenteric white adipose tissue are well-known features of IBD and especially of Crohn’s disease, we discuss the possible crosstalk between adipokines and myokines released from skeletal muscle during exercise with moderate or forced intensity. The emerging role of microbiota and the antioxidative and anti-inflammatory enzymes such as intestinal alkaline phosphatase is also discussed, in order to open new avenues for the therapy against intestinal perturbations associated with IBD.

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Section: Effect Of Obesity On the Course Of Ibdmentioning

confidence: 99%

Section: Effect Of Obesity On the Course Of Ibdmentioning

confidence: 99%

Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

et al. 2019

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“…Inflammatory bowel disease (IBD) and obesity are increasing in incidence and prevalence worldwide ( 1 ). Increased adiposity has been shown to worsen the clinical outcomes of IBD including increased frequency of disease flares, postoperative recurrence, and stricturing/penetrating complications ( 2 – 6 ). The antitumor necrosis factor-alpha (TNFα) agents are effective in treating IBD but have a primary nonresponse rate of 10%–30% and secondary loss of response (SLOR) rate of 10%–15% per year ( 7 ), which may be attributed to several patient and disease- and treatment-related factors.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Adiposity on Anti–Tumor Necrosis Factor-Alpha Levels and Loss of Response in Crohn's Disease Patients

Lim

Welman

Raymond

et al. 2020

Clin Transl Gastroenterol

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INTRODUCTION: A high body mass index is known to adversely affect antitumor necrosis factor-alpha trough levels and secondary loss of response (SLOR) in patients with Crohn's disease. We hypothesize that high levels of adiposity negatively affect these outcomes and aimed to determine if this relationship exists. METHODS: We performed a retrospective cross-sectional study of 69 patients with Crohn's disease from two tertiary inflammatory bowel disease centers between February 1, 2015, and June 30, 2018. Primary responders to infliximab (IFX) or adalimumab (ADA) who had a trough level performed within 6 months of CT or MRI scan and at least 12 months of clinical follow-up were eligible for inclusion. Body composition as measured on CT/MRI scans were correlated with trough concentration and time SLOR. Multivariate adjustments were made for established risk factors known to affect trough levels and SLOR. RESULTS: Of 69 included patients, 44 (63.8%) and 25 (36.2%) patients received IFX and ADA, respectively. Multivariate analysis revealed that IFX trough concentrations were inversely correlated with visceral fat area (−0.02 [−0.04, −0.003], P = 0.03), visceral fat index (−0.07 [−0.12, −0.01], P = 0.02) and visceral fat: skeletal muscle area ratio (−3.81 [−7.13, −0.50], P = 0.03), but not body mass index (−0.23 [−0.52, 0.06], P = 0.11). No predictive factors were found for ADA. Increased total adipose area was associated with an increased risk of SLOR in ADA-treated patients, but not IFX-treated patients (hazard ratio = 1.01 [1.002, 1.016], P = 0.011). DISCUSSION: Visceral adiposity is an important predictor of IFX trough levels, and high total adiposity predicts for SLOR to ADA.

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“…31 Furthermore, a study in adults has shown an association between visceral adiposity and stricturing behaviour in patients with CD. 32 Obesity rates in children with IBD based on BMI assessment range between 8.4% and 16% in a number of studies. [9][10][11][12] In two of these studies, obesity is more prevalent in UC patients than CD patients.…”

Section: Discussionmentioning

confidence: 99%

Body composition profile of children and adolescent patients with inflammatory bowel disease

Alsufyani

Mosli

Saadah

2021

Int. J. Clin. Pract.

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Dual-energy x-ray absorptiometry (DXA) has been widely used to detect low bone mineral density (BMD). The DXA scan can also be calibrated to provide useful data about body composition, including fat mass, lean mass, percentage fat and bone mineral content (BMC).These parameters of body composition can provide information about the nutritional status of children that are undernourished or overnourished compared with healthy children, matched for gender, age and ethnicity. 1 Body mass index (BMI) has been traditionally used to determine the nutritional status of children. However, since total body mass includes bone mineral content, fat mass, and lean soft tissue mass, body composition measurements may reflect the severity of a chronic illness with an accuracy that cannot be detected by BMI. 2 The sensitivity of BMI in detecting obesity in children has generally been reported as low. 3 In one study, BMI was found to misidentify one in four children with obesity if used alone. 4 DXA can provide a more reliable measurement of fat content than BMI, including fat mass as well as fat percentage. 5,6 Children with inflammatory bowel

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Visceral Adipose Tissue Is Associated With Stricturing Crohn’s Disease Behavior, Fecal Calprotectin, and Quality of Life

Abstract: VAT:SAT, rather than BMI, is associated with stricturing CD behavior, elevated FC, and reduced QoL in a disease distribution-dependent manner. Further studies are required to substantiate the role of VAT as a useful biomarker in CD.

Cited by 49 publications

References 26 publications

Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

The Effect of Adiposity on Anti–Tumor Necrosis Factor-Alpha Levels and Loss of Response in Crohn's Disease Patients

Body composition profile of children and adolescent patients with inflammatory bowel disease

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