Obesity is Associated With Increased Risk of Crohn's disease, but not Ulcerative Colitis: A Pooled Analysis of Five Prospective Cohort Studies

Research output: Contribution to journalJournal articleResearchpeer-review

Documents

  • Fulltext

    Final published version, 673 KB, PDF document

  • Simon S.M. Chan
  • Ye Chen
  • Kevin Casey
  • Ola Olen
  • Jonas F. Ludvigsson
  • Franck Carbonnel
  • Bas Oldenburg
  • Marc J. Gunter
  • Tjønneland, Anne
  • Olof Grip
  • Pilar Amian
  • Aurelio Barricarte
  • Manuela M. Bergmann
  • Marie Christine Boutron-Ruault
  • Amanda Cross
  • Andrew R. Hart
  • Rudolf Kaaks
  • Tim Key
  • María Dolores Chirlaque López
  • Luben Robert Luben
  • Giovanna Masala
  • Jonas Manjer
  • Anja Olsen
  • Kim Overvad
  • Domenico Palli
  • Elio Riboli
  • Maria José Sánchez
  • Rosario Tumino
  • Roel Vermeulen
  • W. M.Monique Verschuren
  • Nick Wareham
  • Ashwin Ananthakrishnan
  • Kristin Burke
  • Emily Walsh Lopes
  • James Richter
  • Paul Lochhead
  • Andrew T. Chan
  • Alicia Wolk
  • Hamed Khalili
  • DEFINe-IBD Investigators

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.

Original languageEnglish
JournalClinical Gastroenterology and Hepatology
Pages (from-to)1048-1058
Number of pages11
ISSN1542-3565
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2021 by the AGA Institute. Published by Elsevier, Inc.

    Research areas

  • Body Mass Index, Epidemiology, Inflammatory Bowel Diseases, Waist-Hip Ratio

ID: 286490659