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. 2019 Apr;114(4):630-639.
doi: 10.14309/ajg.0000000000000197.

Impact of Obesity on Disease Activity and Patient-Reported Outcomes Measurement Information System (PROMIS) in Inflammatory Bowel Diseases

Animesh Jain  1 , Nghia H Nguyen  2 , James A Proudfoot  3 , Christopher F Martin  1 , William J Sandborn  2 , Michael D Kappelman  4 , Millie D Long  1 , Siddharth Singh  2   5
Affiliations

Impact of Obesity on Disease Activity and Patient-Reported Outcomes Measurement Information System (PROMIS) in Inflammatory Bowel Diseases

Animesh Jain et al. Am J Gastroenterol. 2019 Apr.

Abstract

Introduction: We conducted a cohort study on the impact of obesity on disease activity and Patient-Reported Outcomes Measurement Information System (PROMIS) measures in the inflammatory bowel disease (IBD) Partners cohort.

Methods: We performed a cross-sectional and longitudinal study within IBD Partners, an internet-based cohort of >15,000 patients living with Crohn's disease (CD) and ulcerative colitis (UC). We included adult patients with IBD, with recorded body mass index (BMI), with at least 6 months of follow-up, excluding patients with BMI < 18.5 kg/m. We evaluated the independent effect of World Health Organization classes of obesity on risk of clinical relapse or persistent disease activity (using validated disease activity indexes) and PROMIS measures, using multivariate logistic regression and linear regression, respectively.

Results: We included 7,296 patients with IBD (4,748 patients with CD, 19.5% obese; 2,548 patients with UC with intact colon, 20.3% obese). Obesity was independently, and in a dose-dependent fashion, associated with an increased risk of persistent disease activity or relapse in both patients with CD (class II or III obesity vs normal BMI: adjusted odds ratio, 1.86; 95% confidence interval, 1.30-2.68) and UC (adjusted odds ratio, 2.97; 95% confidence interval, 1.75-5.17). Obesity was also independently associated with higher anxiety, depression, fatigue, pain, and inferior social function scores in patients with CD and UC at baseline and with worsening depression, fatigue, pain, and social function in patients with CD on longitudinal assessment.

Discussion: Obesity at baseline is independently associated with worsening disease activity and PROMIS measures in patients with IBD.

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Figures

Figure 1.
Figure 1.
Proportion of patients in clinical remission at baseline, based on body mass index
Figure 2.
Figure 2.
Impact of obesity on clinical disease activity in patients with Crohn’s disease on longitudinal follow-up: (A) proportion of patients with active disease, regardless of baseline disease activity, (B) proportion of patients with relapse in subset of patients in remission at baseline, (C) proportion of patients with persistent disease activity in subset of patients with active disease at baseline
Figure 2.
Figure 2.
Impact of obesity on clinical disease activity in patients with Crohn’s disease on longitudinal follow-up: (A) proportion of patients with active disease, regardless of baseline disease activity, (B) proportion of patients with relapse in subset of patients in remission at baseline, (C) proportion of patients with persistent disease activity in subset of patients with active disease at baseline
Figure 2.
Figure 2.
Impact of obesity on clinical disease activity in patients with Crohn’s disease on longitudinal follow-up: (A) proportion of patients with active disease, regardless of baseline disease activity, (B) proportion of patients with relapse in subset of patients in remission at baseline, (C) proportion of patients with persistent disease activity in subset of patients with active disease at baseline
Figure 3.
Figure 3.
Impact of obesity on clinical disease activity in patients with ulcerative colitis on longitudinal follow-up: (A) proportion of patients with active disease, regardless of baseline disease activity, (B) proportion of patients with relapse in subset of patients in remission at baseline, (C) proportion of patients with persistent disease activity in subset of patients with active disease at baseline
Figure 3.
Figure 3.
Impact of obesity on clinical disease activity in patients with ulcerative colitis on longitudinal follow-up: (A) proportion of patients with active disease, regardless of baseline disease activity, (B) proportion of patients with relapse in subset of patients in remission at baseline, (C) proportion of patients with persistent disease activity in subset of patients with active disease at baseline
Figure 3.
Figure 3.
Impact of obesity on clinical disease activity in patients with ulcerative colitis on longitudinal follow-up: (A) proportion of patients with active disease, regardless of baseline disease activity, (B) proportion of patients with relapse in subset of patients in remission at baseline, (C) proportion of patients with persistent disease activity in subset of patients with active disease at baseline
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References

    1. Singh S, Dulai PS, Zarrinpar A, et al. Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes. Nat Rev Gastroenterol Hepatol 2016;30:30. - PMC - PubMed
    1. Flores A, Burstein E, Cipher DJ, et al. Obesity in Inflammatory Bowel Disease: A Marker of Less Severe Disease. Dig Dis Sci 2015;60:2436–45. - PubMed
    1. Singla MB, Eickhoff C, Betteridge J. Extraintestinal Manifestations Are Common in Obese Patients with Crohn’s Disease. Inflamm Bowel Dis 2017;23:1637–1642. - PubMed
    1. Seminerio JL, Koutroubakis IE, Ramos-Rivers C, et al. Impact of Obesity on the Management and Clinical Course of Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis 2015;21:2857–63. - PubMed
    1. Nguyen NH, Ohno-Machado L, Sandborn WJ, et al. Obesity is Independently Associated with Higher Annual Burden and Costs of Hospitalization in Patients with Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol 2018; doi: 10.1016/j.cgh.2018.07.004. - DOI - PubMed

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