Visceral adiposity and inflammatory bowel disease

Area of Science:

• Gastroenterology and Hepatology
• Obesity Research
• Inflammatory Bowel Disease (IBD) Research

Background:

• Rising global rates of obesity and inflammatory bowel disease (IBD) highlight the need to understand their interconnectedness.
• Obesity, particularly visceral adiposity, is increasingly recognized as a pro-inflammatory state potentially exacerbating IBD.
• Visceral fat accumulation may correlate with more severe inflammatory phenotypes in IBD patients.

Purpose of the Study:

• To systematically review and summarize existing literature on the association between visceral adiposity and IBD outcomes.
• To identify patterns and evidence linking visceral fat accumulation to disease severity, phenotype, and treatment response in IBD.
• To highlight gaps in current research and suggest future directions for understanding the role of visceral adiposity in IBD.

Main Methods:

• Comprehensive literature search of PubMed/MEDLINE and Embase databases using relevant keywords and Boolean phrases.
• Inclusion of grey literature and manual searches to ensure a thorough review of available studies.
• Systematic selection of abstracts and full-text articles by two independent reviewers, followed by data extraction and quality assessment.

Main Results:

• A total of 22 full-text articles were included, predominantly retrospective studies of moderate to weak quality.
• Evidence suggests higher visceral fat content in Crohn's disease (CD) patients compared to healthy controls.
• Visceral adiposity is associated with an increased risk of complex CD phenotypes and higher post-operative recurrence rates, particularly with increased mesenteric adiposity.

Conclusions:

• Visceral adiposity appears elevated in Crohn's disease and may be linked to more complex disease manifestations.
• Increasing mesenteric adiposity shows a potential association with post-operative recurrence rates in IBD.
• Further high-quality research is essential to clarify the relationship between visceral adiposity and IBD, especially in ulcerative colitis (UC) patients, and its impact on patient outcomes.