Severe Obesity, a Susceptibility Factor for Developing Inflammatory Bowel Disease: Results of a Population-Based Study.

Fiorella Cañete,Emili Vela,Margalida Calafat, Jordi Piera,Míriam Mañosa,Eugeni Domènech

Journal of Crohn's & colitis（2025）

Servei d'Aparell Digestiu

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Abstract

BACKGROUND AND AIMS:Inflammatory bowel disease (IBD) develops in genetically susceptible individuals exposed to certain environmental factors, of which only a few have been established. We aimed to assess whether bariatric surgery (BS) and severe obesity are associated with an increased risk of developing IBD. METHODS:Adults diagnosed with obesity or severe obesity between 2005 and 2020 were identified from the Catalan Health Surveillance System; those diagnosed with IBD prior to the diagnosis of obesity or severe obesity were excluded. Individuals who had undergone BS and those with a new diagnosis of IBD were identified and their likelihood of developing IBD was analyzed. RESULTS:A total of 93 473 individuals with severe obesity, 1 009 256 with obesity and 14 698 who underwent BS were identified. The incidence rates of IBD among individuals who had undergone BS prior to IBD diagnosis was 0.84 cases per 1000 person-years, 0.90 cases per 1000 person-years among individuals with severe obesity without BS and 0.60 cases per 1000 person-years in individuals with obesity. In the multivariable regression analysis, severe obesity (hazard ratio [HR] 1.46; 95% confidence interval [95%CI] 1.31-1.62), BS (HR 1.57; 95%CI 1.25-1.97), and smoking habit (HR 1.57; 95%CI 1.46-1.69) were risk factors for developing IBD (as well as for Crohn's disease and ulcerative colitis). CONCLUSIONS:Severe obesity and BS were independent risk factors for the development of IBD. noninvasive screening for IBD seems to be warranted in this population.

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【要点】：该研究通过人口基础研究揭示了严重肥胖和减重手术是炎症性肠病（IBD）的独立危险因素。

【方法】：研究利用加泰罗尼亚卫生监测系统数据，分析了2005至2020年间诊断为肥胖或严重肥胖的成年人，排除了之前已被诊断为IBD的个体，通过比较接受减重手术的个体和未接受手术的肥胖个体中IBD的发病率，来确定风险因素。

【实验】：共识别了93,473名严重肥胖者、1,009,256名肥胖者和14,698名接受减重手术者，分析了他们的IBD发病率，发现接受减重手术的个体IBD发病率为0.84例/1000人年，未接受手术的严重肥胖者为0.90例/1000人年，肥胖者为0.60例/1000人年。多变量回归分析显示，严重肥胖、减重手术和吸烟习惯是IBD的危险因素。