Obesity is Associated With Increased Risk of Crohn's disease, but not Ulcerative Colitis: A Pooled Analysis of Five Prospective Cohort Studies
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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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Clinical Gastroenterology and Hepatology |
| Sider (fra-til) | 1048-1058 |
| Antal sider | 11 |
| ISSN | 1542-3565 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Conflicts of interest These authors disclose the following: Simon S. M. Chan has received travel grants from Abbvie and Takeda. Karolinska Institutet has received investigator-initiated study grants and fees for lectures and consulting performed by Ola Olén for Janssen, Pfizer, Ferring, and Takeda. Jonas F. Ludvigsson coordinates a study on behalf of the Swedish Inflammatory Bowel Disease quality register (SWIBREG) that has received funding from Janssen Corporation. Andrew T. Chan serves as a consultant for Janssen Pharmaceuticals, Pfizer Inc, and Bayer Pharma AG, and Boehringer Ingelheim for work unrelated to the topic of this manuscript. Hamed Khalili receives grant funding from Takeda and Pfizer. He has also received consulting fees from AbbVie and Takeda. The remaining authors disclose no conflicts.
Funding Information:
The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer . The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue Contre le Cancer , Institut Gustave Roussy , Mutuelle Générale de l’Education Nationale, and Institut National de la Santé et de la Recherche Médicale (Inserm), (France); Deutsche Krebshilfe , Deutsches Krebsforschungszentrum , and Federal Ministry of Education and Research (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health , Welfare, and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund, and Statistics Netherlands (the Netherlands); Health Research Fund, Instituto de Salud Carlos III , regional governments of Andalucía, Basque Country, Murcia, and Navarra, and the Catalan Institute of Oncology (Spain); Swedish Cancer Society , Swedish Scientific Council, and county councils of Skåne and Västerbotten (Sweden); Medical Research Council ( MR/N003284/1 , MC-PC_13048 and MC-UU_12015/1 to EPIC-Norfolk (DOI 10.22025/2019.10.105.00004 ), Medical Research Council ( MR/M012190/1 ) and Cancer Research UK ( C8221/A29017 ) to EPIC-Oxford (UK). The funders had no role in the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.
Funding Information:
The NHS and NHSII are supported by grants ( UM1 CA186107 , U01 CA176726 ) from the National Institutes of Health . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Funding This work is supported by senior research grants by the US Crohn's and Colitis Foundation to HK, AW, and ATC.The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by the Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle G?n?rale de l'Education Nationale, and Institut National de la Sant? et de la Recherche M?dicale (Inserm), (France); Deutsche Krebshilfe, Deutsches Krebsforschungszentrum, and Federal Ministry of Education and Research (Germany); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare, and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund, and Statistics Netherlands (the Netherlands); Health Research Fund, Instituto de Salud Carlos III, regional governments of Andaluc?a, Basque Country, Murcia, and Navarra, and the Catalan Institute of Oncology (Spain); Swedish Cancer Society, Swedish Scientific Council, and county councils of Sk?ne and V?sterbotten (Sweden); Medical Research Council (MR/N003284/1, MC-PC_13048 and MC-UU_12015/1 to EPIC-Norfolk (DOI 10.22025/2019.10.105.00004), Medical Research Council (MR/M012190/1) and Cancer Research UK (C8221/A29017) to EPIC-Oxford (UK). The funders had no role in the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.The NHS and NHSII are supported by grants (UM1 CA186107, U01 CA176726) from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflicts of interest These authors disclose the following: Simon S. M. Chan has received travel grants from Abbvie and Takeda. Karolinska Institutet has received investigator-initiated study grants and fees for lectures and consulting performed by Ola Ol?n for Janssen, Pfizer, Ferring, and Takeda. Jonas F. Ludvigsson coordinates a study on behalf of the Swedish Inflammatory Bowel Disease quality register (SWIBREG) that has received funding from Janssen Corporation. Andrew T. Chan serves as a consultant for Janssen Pharmaceuticals, Pfizer Inc, and Bayer Pharma AG, and Boehringer Ingelheim for work unrelated to the topic of this manuscript. Hamed Khalili receives grant funding from Takeda and Pfizer. He has also received consulting fees from AbbVie and Takeda. The remaining authors disclose no conflicts.
Funding Information:
Funding This work is supported by senior research grants by the US Crohn’s and Colitis Foundation to HK, AW, and ATC.
Publisher Copyright:
© 2021 by the AGA Institute. Published by Elsevier, Inc.
ID: 286490659