Adults with Crohn’s disease exhibit elevated gynoid fat and reduced android fat irrespective of disease relapse or remission

Abstract

Crohn’s disease (CD) is a debilitating inflammatory bowel condition of unknown aetiology that is growing in prevalence globally. Large-scale studies have determined associations between female obesity or low body mass index (BMI) with risk of CD at all ages or 8– < 40 years, respectively. For males, low BMI entering adult life is associated with increased incidence of CD or ulcerative colitis up to 40 years later. Body composition analysis has shown that combinations of lean tissue loss and high visceral fat predict poor CD outcomes. Here, we assessed dietary intake, physical activity and whole or regional body composition of patients with CD relapse or remission. This anthropometric approach found people with CD, irrespective of relapse or remission, differed from a large representative healthy population sample in exhibiting elevated gynoid fat and reduced android fat. CD is associated with mesenteric adipose tissue, or “creeping fat”, that envelops affected intestine exclusive of other tissue; that fat is localised to the android region of the body. In this context, CD mesenteric adiposity represents a stark juxtaposition of organ-specific and regional adiposity. Although our study population was relatively small, we suggest tentatively that there is a rationale to refer to Crohn’s disease as a fatty intestine condition, akin to fatty liver conditions. We suggest that our data provide early insight into a subject that potentially warrants further investigation across a larger patient cohort.

Physical activity in inflammatory bowel disease: benefits, challenges and perspectives

“…However, strenuous activity and total daily physical activity were positively associated with complete mucosal healing within the last 6 months. Similar results were found in a small cohort study of CD patients [14]. The physical activity level measured with actigraphy was not different between remising and relapsing patients.…”

Relationship between SIRI and android and gynoid fat related to obesity and cardiovascular risk: a cross-sectional study of NHANES 2017–2018

“…Crohn's disease is a representative chronic inflammatory disease. In contrast to the conclusions of most studies, 18,19 Dowling et al 20 found that adult patients with Crohn's disease exhibited less fat in the android region and more fat in the gynoid region compared with the healthy population, independent of changes in disease. The mesenteric adipose tissue encapsulating the diseased intestine, also known as "creeping fat," is a protective barrier against inflammatory mediators and intestinal bacterial translocation, 21 and its presence is limited to the android region.…”

Body Composition in Inflammatory Bowel Disease

“… 7 Furthermore, a recent study showed the male patients of the participating CD had significantly higher BMI compared to the general healthy Irish population, while lean tissue mass was similar. 8 In addition, the majority of body fat was located in the abdominal or trunk region, 8 such as mesenteric creeping fat. All the above studies indicate that BMI cannot account for fat distribution without distinction between lean and fat mass.…”