Obesity is Associated With Increased Risk of Crohn's disease, but not Ulcerative Colitis : A Pooled Analysis of Five Prospective Cohort Studies
(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.
(Less)
- author
- contributor
- Manjer, Jonas LU
- author collaboration
- publishing date
- 2022
- 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 <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}}, }