Impact of Metabolic Syndrome on the Hospitalization Rate of Crohn's Disease Patients Seen at a Tertiary Care Center: A Retrospective Cohort Study

Fitzmorris, Paul; Colantonio, Lisandro D.; Perez, Euriko Torrazza; Smith, Ioana; Kakati, Donny; Malik, Talha A.

doi:10.1159/000380763

Cited by 18 publications

(18 citation statements)

References 16 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a single-centre retrospective cohort study of 868 patients with Crohn’s disease (19.0% of whom were obese), an increased incidence of IBD-related hospitalization was observed in the 4% of the cohort with metabolic syndrome (defined as >3 of the following features: obesity, diabetes mellitus, hypertension, high levels of circulating triglycerides and low levels of circulating HDL cholesterol), compared with those without metabolic syndrome (incidence rate ratio 1.79, 95% CI 1.06–3.00). However, on evaluating different components of metabolic syndrome, presence of diabetes mellitus, high circulating triglyceride levels and low HDL cholesterol levels, but not obesity, were associated with increased incidence of IBD-related hospitalization 81 . In another retrospective cohort study of 240 patients with Crohn’s disease (12.5% of whom were obese), although obesity was identified as a risk factor for surgery on univariate analysis (OR 2.2, 95% CI 1.0–4.8), it was not an independent predictor of surgery after adjustment for confounding variables.…”

Section: Effect Of Obesity On Ibd Coursementioning

confidence: 92%

Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes

Singh

Dulai

Zarrinpar

et al. 2016

Nat Rev Gastroenterol Hepatol

308

285

View full text Add to dashboard Cite

Incidence of IBD is rising in parallel with overweight and obesity. Contrary to conventional belief, about 15–40% of patients with IBD are obese, which might contribute to the development of IBD. Findings from cross-sectional and retrospective cohort studies are conflicting on the effect of obesity on natural history and course of IBD. Most studies are limited by small sample size, low event rates, non-validated assessment of disease activity and lack robust longitudinal follow-up and have incomplete adjustment for confounding factors. The effect of obesity on the efficacy of IBD-related therapy remains to be studied, though data from other autoimmune diseases suggests that obesity results in suboptimal response to therapy, potentially by promoting rapid clearance of biologic agents leading to low trough concentrations. These data provide a rationale for using weight loss interventions as adjunctive therapy in patients with IBD who are obese. Obesity also makes colorectal surgery technically challenging and might increase the risk of perioperative complications. In this Review, we highlight the existing literature on the epidemiology of obesity in IBD, discuss its plausible role in disease pathogenesis and effect on disease course and treatment response, and identify high-priority areas of future research.

show abstract

Section: Effect Of Obesity On Ibd Coursementioning

confidence: 92%

Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes

Singh

Dulai

Zarrinpar

et al. 2016

Nat Rev Gastroenterol Hepatol

308

285

View full text Add to dashboard Cite

show abstract

“…While markers of metabolic syndrome and C-reactive protein were more frequently increased, no association between BMI and need for hospitalization, surgery or medication alterations were noted [140]. Contrarily in CD, the presence of metabolic syndrome increased the risk of hospitalization twofold [141]. In addition a report from France suggested that obese patients with CD had more perianal disease and needed more hospitalizations [142], but in a further study a more mild disease course was found in obese patients with CD [143].…”

Section: Impact Of Obesity On Clinical Outcome Of Ibdmentioning

confidence: 95%

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

Szilagyi

2019

Clin J Gastroenterol

View full text Add to dashboard Cite

The inflammatory bowel diseases, Crohn's and ulcerative colitis have increased in incidence and prevalence from the mideighteen to the late nineteen centuries. From then to the current twenty-first century there has been a more rapid expansion of these disease to areas previously experiencing low rates. This latter expansion coincides with the current obesity pandemic which also began toward the end of the last century. Although the two diseases have radically different frequencies, there are interesting links between them. Four areas link the diseases. On an epidemiological level, IBD tends to follow a northsouth gradient raising the importance of vitamin D in protection. Obesity has very weak relationship with latitude, but both diseases follow adult lactase distributions colliding in this plane. Is it possible that obesity (a low vitamin D condition with questionable response to supplements) reduces effects in IBD? On a pathogenic level, pro-inflammatory processes mark both IBD and obesity. The similarity raises the question of whether obesity could facilitate the development of IBD. Features of the metabolic syndrome occur in both, with or without obesity in IBD. The fourth interaction between the two diseases is the apparent effect of obesity on the course of IBD. There are suggestions that obesity may reduce the efficacy of biologic agents. Yet there is some suggestion also that obesity may reduce the need for hospitalization and surgery. The apparent co-expansion of both obesity and IBD suggests similar environmental changes may be involved in the promotion of both.

show abstract

“…Interestingly, also higher abundances of Bacteroides species were found in patients with IBD compared to healthy individuals (112, 113), suggesting that a disturbance of the gut microbial balance in favor of Bacteroides is linked to inflammation of the GI tract. IBD is relatively frequently associated with MetS (114, 115), which adds to the possibility that Bacteroides abundance and disturbances in the inflammatory system are linked. The direction of this relation is currently unclear.…”

Section: Bacteroidesmentioning

confidence: 99%

The Role of Supplemental Complex Dietary Carbohydrates and Gut Microbiota in Promoting Cardiometabolic and Immunological Health in Obesity: Lessons from Healthy Non-Obese Individuals

2017

View full text Add to dashboard Cite

Dietary supplementation with complex carbohydrates is known to alter the composition of gut microbiota, and optimal implementation of the use of these so called “prebiotics” could be of great potential in prevention and possibly treatment of obesity and associated cardiometabolic and inflammatory diseases via changes in the gut microbiota. An alternative to this “microbiocentric view” is the idea that health-promoting effects of certain complex carbohydrates reside in the host, and could secondarily affect the diversity and abundance of gut microbiota. To circumvent this potential interpretational problem, we aimed at providing an overview about whether and how dietary supplementation of different complex carbohydrates changes the gut microbiome in healthy non-obese individuals. We then reviewed whether the reported changes in gut bacterial members found to be established by complex carbohydrates would benefit or harm the cardiometabolic and immunological health of the host taking into account the alterations in the microbiome composition and abundance known to be associated with obesity and its associated disorders. By combining these research areas, we aimed to give a better insight into the potential of (foods containing) complex carbohydrates in the treatment and prevention of above-mentioned diseases. We conclude that supplemental complex carbohydrates that increase Bifidobacteria and Lactobacilli, without increasing the deleterious Bacteroides, are most likely promoting cardiometabolic and immunological health in obese subjects. Because certain complex carbohydrates also affect the host’s immunity directly, it is likely that host–microbiome interactions in determination of health and disease characteristics are indeed bidirectional. Overall, this review article shows that whereas it is relatively clear in which direction supplemental fermentable carbohydrates can alter the gut microbiome, the relevance of these changes regarding health remains controversial. Future research should take into account the different causes of obesity and its adverse health conditions, which in turn have drastic effects on the microbiome balance.

show abstract

Impact of Metabolic Syndrome on the Hospitalization Rate of Crohn's Disease Patients Seen at a Tertiary Care Center: A Retrospective Cohort Study

Cited by 18 publications

References 16 publications

Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes

Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

The Role of Supplemental Complex Dietary Carbohydrates and Gut Microbiota in Promoting Cardiometabolic and Immunological Health in Obesity: Lessons from Healthy Non-Obese Individuals

Contact Info

Product

Resources

About