以体重指数评估的营养状况与克罗恩病表型之间的关系:全国性分析

IF 2.9 Q3 NUTRITION & DIETETICS Clinical nutrition ESPEN Pub Date : 2024-10-17 DOI:10.1016/j.clnesp.2024.09.033
Judwin Ndzo , Sudheer K. Vuyyuru , Thomas Trimble , Kaung Yan , Grazziela Figueredo , Gordon W. Moran
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引用次数: 0

摘要

背景与目的:肥胖症和克罗恩病(CD)的发病率在全球范围内呈上升趋势。因此,了解肥胖与疾病表型之间的关系至关重要。我们的目的是利用一个大型全国可回收数据集,探讨以体重指数(BMI)衡量的营养状况与克罗恩病表型之间的关系:我们利用国家健康与护理研究所-IBD 生物资源数据库,通过逻辑回归法回顾性地评估了体重指数与狭窄性 CD 之间的关系。BMI是主要相关变量;CD行为是因变量;狭窄性CD是主要结果。在多变量模型中对混杂因素进行了调整:共纳入了 8,797 名在 1942 年至 2020 年间确诊的患者。总体平均体重指数为 26.3kg/m2(SD5.5)。52.7%的患者体重指数≥25kg/m2(平均 30.2kg/m2,SD 4.5)。大多数人患有炎症性 CD(62.9%),其次是狭窄性 CD(25.1%)和穿透性 CD(12%)。狭窄性和穿透性 CD 在体重指数为 2 的组别中更为常见(分别为 50.7%和 50.3%):经过多变量分析,BMI、回肠疾病位置和生物制剂的使用与狭窄性疾病表型呈负相关。这可能反映了与狭窄性疾病有关的持续性餐后症状导致的饮食行为的改变。需要进行大型纵向研究,以调查肥胖状态与肠纤维化之间可能存在的时间关系。
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Association between nutritional status assessed by body mass index and Crohn's disease phenotype: A Nation-wide analysis

Background & aims

Incidence of obesity and Crohn's disease (CD) is increasing globally. Therefore, understanding any associations between adiposity and disease phenotype is crucial. We aimed explore the relationship between nutritional status measured by body mass index (BMI) and phenotypes of CD using a large national recallable data set.

Methods

Using National Institute for Health and Care Research-IBD Bioresource data base, we retrospectively assessed the relationship between BMI and stenosing CD by logistic regression. BMI was the primary variable of interest; CD behaviour was the dependent variable; stenosing CD was the primary outcome. Confounders were adjusted for in a multivariate model.

Results

8797 patients diagnosed between 1942 and 2020 were included. Mean overall BMI was 26.3 kg/m2 (SD5.5). 52.7 % had a BMI ≥25 kg/m2 (mean 30.2 kg/m2, SD 4.5). Majority had inflammatory CD (62.9 %) followed by stenosing (25.1 %) and penetrating CD (12 %). Stenosing and penetrating phenotypes were more common in the <25 kg/m2 BMI group (50.7 %, 50.3 % respectively) p < 0.001. Colonic disease location was more common (27.8 % vs 24.3 %, p = 0.001) in patients with high BMI. On univariate analysis, stenosing disease was positively associated with ileal disease location, disease duration, previous surgery, use of infliximab, ustekinumab, vedolizumab, adalimumab and azathioprine but negatively associated with BMI (OR 0.98, 95%CI [0.968–0.99]). On multivariate analyses, BMI remained negatively associated with stenosing CD (OR 0.98, 95%CI [0.97–0.99]); ileal disease location (OR 3.69, 95%CI [3.22–4.24]), adalimumab (OR 1.47, 95%CI [1.30–1.66]), ustekinumab usage (OR 1.51, 95%CI [1.14–2.01] and azathioprine (OR 1.35, 95%CI [1.19–1.53]).

Conclusions

After multivariate analyses, BMI, ileal disease location and biologic use was negatively associated with a stenosing disease phenotype. This might reflect a change in eating behaviour due to persistent postprandial symptoms related to stenosing disease. Large longitudinal studies are needed to investigate any possible temporal relationship between the obesogenic state and intestinal fibrosis.
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来源期刊
Clinical nutrition ESPEN
Clinical nutrition ESPEN NUTRITION & DIETETICS-
CiteScore
4.90
自引率
3.30%
发文量
512
期刊介绍: Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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