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Obesity is Associated With Increased Risk of Crohn's disease, but not Ulcerative Colitis : A Pooled Analysis of Five Prospective Cohort Studies

Chan, Simon S.M. ; Chen, Ye ; Casey, Kevin ; Olen, Ola ; Ludvigsson, Jonas F. ; Carbonnel, Franck ; Oldenburg, Bas ; Gunter, Marc J. ; Tjønneland, Anne and Grip, Olof LU , et al. (2022) In Clinical Gastroenterology and Hepatology 20(5). p.1048-1058
Abstract

Background and Aims: It is unclear whether obesity is associated with the development of inflammatory bowel disease despite compelling data from basic science studies. We therefore examined the association between obesity and risk of Crohn's disease (CD) and ulcerative colitis (UC). Methods: We conducted pooled analyses of 5 prospective cohorts with validated anthropometric measurements for body mass index (BMI) and waist-hip ratio and other lifestyle factors. Diagnoses of CD and UC were confirmed through medical records or ascertained using validated definitions. We used Cox proportional hazards modeling to calculate pooled multivariable-adjusted HRs (aHRs) and 95% confidence intervals (CIs). Results: Among 601,009 participants (age... (More)

Background and Aims: It is unclear whether obesity is associated with the development of inflammatory bowel disease despite compelling data from basic science studies. We therefore examined the association between obesity and risk of Crohn's disease (CD) and ulcerative colitis (UC). Methods: We conducted pooled analyses of 5 prospective cohorts with validated anthropometric measurements for body mass index (BMI) and waist-hip ratio and other lifestyle factors. Diagnoses of CD and UC were confirmed through medical records or ascertained using validated definitions. We used Cox proportional hazards modeling to calculate pooled multivariable-adjusted HRs (aHRs) and 95% confidence intervals (CIs). Results: Among 601,009 participants (age range, 18-98 years) with 10,110,018 person-years of follow-up, we confirmed 563 incident cases of CD and 1047 incident cases of UC. Obesity (baseline BMI ≥30 kg/m2) was associated with an increased risk of CD (pooled aHR, 1.34; 95% CI, 1.05-1.71, I2 = 0%) compared with normal BMI (18.5 to <25 kg/m2). Each 5 kg/m2 increment in baseline BMI was associated with a 16% increase in risk of CD (pooled aHR, 1.16; 95% CI, 1.05-1.22; I2 = 0%). Similarly, with each 5 kg/m2 increment in early adulthood BMI (age, 18-20 years), there was a 22% increase in risk of CD (pooled aHR, 1.22; 95% CI, 1.05-1.40; I2 = 13.6%). An increase in waist-hip ratio was associated with an increased risk of CD that did not reach statistical significance (pooled aHR across quartiles, 1.08; 95% CI, 0.97-1.19; I2 = 0%). No associations were observed between measures of obesity and risk of UC. Conclusions: In an adult population, obesity as measured by BMI was associated with an increased risk of older-onset CD but not UC.

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contributor
LU
author collaboration
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Body Mass Index, Epidemiology, Inflammatory Bowel Diseases, Waist-Hip Ratio
in
Clinical Gastroenterology and Hepatology
volume
20
issue
5
pages
1048 - 1058
publisher
Elsevier
external identifiers
  • scopus:85113386738
  • pmid:34242756
ISSN
1542-3565
DOI
10.1016/j.cgh.2021.06.049
language
English
LU publication?
no
additional info
Publisher Copyright: © 2021 by the AGA Institute. Published by Elsevier, Inc.
id
c9696eb2-df48-4a5b-bfa9-ae5eb209ac15
date added to LUP
2021-10-13 07:40:53
date last changed
2024-06-15 18:06:12
@article{c9696eb2-df48-4a5b-bfa9-ae5eb209ac15,
  abstract     = {{<p>Background and Aims: It is unclear whether obesity is associated with the development of inflammatory bowel disease despite compelling data from basic science studies. We therefore examined the association between obesity and risk of Crohn's disease (CD) and ulcerative colitis (UC). Methods: We conducted pooled analyses of 5 prospective cohorts with validated anthropometric measurements for body mass index (BMI) and waist-hip ratio and other lifestyle factors. Diagnoses of CD and UC were confirmed through medical records or ascertained using validated definitions. We used Cox proportional hazards modeling to calculate pooled multivariable-adjusted HRs (aHRs) and 95% confidence intervals (CIs). Results: Among 601,009 participants (age range, 18-98 years) with 10,110,018 person-years of follow-up, we confirmed 563 incident cases of CD and 1047 incident cases of UC. Obesity (baseline BMI ≥30 kg/m<sup>2</sup>) was associated with an increased risk of CD (pooled aHR, 1.34; 95% CI, 1.05-1.71, I<sup>2</sup> = 0%) compared with normal BMI (18.5 to &lt;25 kg/m<sup>2</sup>). Each 5 kg/m<sup>2</sup> increment in baseline BMI was associated with a 16% increase in risk of CD (pooled aHR, 1.16; 95% CI, 1.05-1.22; I<sup>2</sup> = 0%). Similarly, with each 5 kg/m<sup>2</sup> increment in early adulthood BMI (age, 18-20 years), there was a 22% increase in risk of CD (pooled aHR, 1.22; 95% CI, 1.05-1.40; I<sup>2</sup> = 13.6%). An increase in waist-hip ratio was associated with an increased risk of CD that did not reach statistical significance (pooled aHR across quartiles, 1.08; 95% CI, 0.97-1.19; I<sup>2</sup> = 0%). No associations were observed between measures of obesity and risk of UC. Conclusions: In an adult population, obesity as measured by BMI was associated with an increased risk of older-onset CD but not UC.</p>}},
  author       = {{Chan, Simon S.M. and Chen, Ye and Casey, Kevin and Olen, Ola and Ludvigsson, Jonas F. and Carbonnel, Franck and Oldenburg, Bas and Gunter, Marc J. and Tjønneland, Anne and Grip, Olof and Lochhead, Paul and Chan, Andrew T. and Wolk, Alicia and Khalili, Hamed}},
  issn         = {{1542-3565}},
  keywords     = {{Body Mass Index; Epidemiology; Inflammatory Bowel Diseases; Waist-Hip Ratio}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1048--1058}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Gastroenterology and Hepatology}},
  title        = {{Obesity is Associated With Increased Risk of Crohn's disease, but not Ulcerative Colitis : A Pooled Analysis of Five Prospective Cohort Studies}},
  url          = {{http://dx.doi.org/10.1016/j.cgh.2021.06.049}},
  doi          = {{10.1016/j.cgh.2021.06.049}},
  volume       = {{20}},
  year         = {{2022}},
}