Obesity is Associated With Increased Risk of Crohn’s disease, but not Ulcerative Colitis: A Pooled Analysis of Five Prospective Cohort Studies
Year: 2021
Type: article
Abstract: 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/m 2 ) was associated with an increased risk of CD (pooled aHR, 1.34; 95% CI, 1.05-1.71, I 2 = 0%) compared with normal BMI (18.5 to <25 kg/m 2 ). Each 5 kg/m 2 increment in baseline BMI was associated with a 16% increase in risk of CD (pooled aHR, 1.16; 95% CI, 1.05-1.22; I 2 = 0%). Similarly, with each 5 kg/m 2 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; I 2 = 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; I 2 = 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.
Authors: Simon S.M. Chan, Ye Chen, Kevin Casey, Ola Olen, Jonas F. Ludvigsson, Franck Carbonnel, Bas Oldenburg, Marc J. Gunter, Anne Tjønneland, 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, 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
Institutions: University of East Anglia, Norfolk and Norwich University Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Harvard University, Massachusetts General Hospital, Karolinska Institutet, Stockholm South General Hospital, Sachs' Children and Youth Hospital, Örebro University Hospital, Inserm, Université Paris-Saclay, Assistance Publique – Hôpitaux de Paris, Centre de recherche en Epidémiologie et Santé des Populations, Bicêtre Hospital, University Medical Center Utrecht, Centre international de recherche sur le cancer, University of Copenhagen, Danish Cancer Society, Skåne University Hospital, Uppsala University, Broad Institute
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $3,800
Funders: Crohn's and Colitis Foundation of America, World Health Organization, Brigham and Women's Hospital, Kræftens Bekæmpelse, Deutsches Krebsforschungszentrum, Centre International de Recherche sur le Cancer, Crohn's and Colitis Foundation, Cancer Research UK, National Institute for Health and Care Research, University of Cambridge, European Commission, Institut National de la Santé et de la Recherche Médicale, Bundesministerium für Bildung und Forschung, Cancerfonden, Ligue Contre le Cancer, Associazione Italiana per la Ricerca sul Cancro, Deutsche Krebshilfe, Institut Gustave-Roussy, Mutuelle Générale de l'Education Nationale, National Institutes of Health, Medical Research Council, World Cancer Research Fund, Instituto de Salud Carlos III, Directorate-General for Health and Food Safety, National Cancer Institute
Awards: Aetiology of type 2 diabetes and related metabolic disorders, G1192877484, G1265254713, G1718233269, G1837345911, G1892934672, G2131326840, G219746026, G2409987178, G2572521044, G2714613917, G2723675273, G2742323354, G294025628, G3216658785, G3328679326, G3730329413, G382879149, G385201875, G3964026636, G4155712275, G4303038735, G4495613716, Health of vegetarians, G4735631659, G4752739612, G4844208673, G4879533352, The EPIC-Norfolk prospective population study: biological and behavioural determinants of health and disease in an ageing population, Core Infrastructure and Methodological Research for Cancer Epidemiology Cohorts, G5271742736, G5294110089, G5406065712, G5897142711, G6025337639, G6085534252, NIHR Senior Investigator Award, G6442500046, G6473583094, G6566148188, G6594529311, G6780254327, G6870695443, G6923329853, G6957823285, G707346186, G7597388277, G8279237360, G848473175, G8871720756, G899966268, G9000043058, G9000058679, G9000099730, G9000157792, Cancer Epidemiology Cohort in Male Health Professionals
OpenAlex ID: W3177899498