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Early-Life Body Mass Index and Inflammatory Bowel Disease Risk: A Scandinavian Birth Cohort Study
Tereza Lerchova1, Johnny Ludvigsson2,3, Staffan Mårild1
1Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Insights
Childhood obesity is linked to a higher risk of developing ulcerative colitis later in life. Further research is needed to understand the connection between childhood body mass index (BMI) and inflammatory bowel disease (IBD).
Area of Science:
- Pediatric Health
- Gastroenterology
- Epidemiology
Background:
- Childhood overweight and obesity represent a growing global health concern with potential impacts on immune function.
- Investigating the relationship between childhood body mass index (BMI) and the risk of developing inflammatory bowel disease (IBD) is crucial.
Purpose of the Study:
- To examine the association between childhood body mass index (BMI) and the subsequent risk of inflammatory bowel disease (IBD).
- To analyze BMI trajectories from birth through childhood and their correlation with IBD development.
Main Methods:
- Utilized two large, population-based Scandinavian birth cohorts (ABIS and MoBa) with long-term prospective follow-up.
- Assessed age-specific BMI percentiles and categories (underweight, normal, overweight, obesity) from birth to 7-8 years.
- Analyzed IBD risk using national health registry data, adjusting for multiple covariates and employing pooled random-effects models.
Main Results:
- A significantly increased risk of ulcerative colitis was observed in children with obesity at 7-8 years (pooled adjusted hazard ratio [aHR] = 5.10).
- No significant association was found between childhood obesity at age 3 and later IBD risk.
- Early-life BMI trajectories did not show consistent associations with the development of IBD.
Conclusions:
- Childhood obesity at 7-8 years is associated with an elevated risk of developing ulcerative colitis.
- The findings highlight the importance of addressing childhood obesity due to its potential long-term health implications.
- Further research is warranted to elucidate the underlying mechanisms connecting childhood obesity and ulcerative colitis.
Introduction:
Childhood overweight and obesity are emerging global health issues with potential implications for immune function. We aimed to investigate childhood body mass index (BMI) as a risk factor for later inflammatory bowel disease (IBD).
Methods:
ABIS (Sweden) and MoBa (Norway) are population-based cohorts following participants prospectively from birth (1997-2009) until 2023. We retrieved anthropometric data at birth, 1, 3, and 7-8 years to examine the association of age-specific standardized BMI percentiles and categories (underweight, normal [reference), overweight, obesity) with later IBD. We also analyzed IBD risk according to BMI trajectories across ages. IBD diagnosis was identified in national health registries. Cohort-specific hazard ratios (aHRs) were adjusted for sociodemographics, parental BMI, IBD, and smoking and pooled using a random-effects model.
Results:
Overall, among 54 890 children with 803 444 person-years of follow-up, we identified 246 IBD events. Eight-year-olds living with obesity had a 5-fold increased risk of ulcerative colitis (pooled aHR = 5.10; 95% CI , 1.51-17.27), but not a significantly increased risk of Crohn's disease (pooled aHR = 1.38; 95% CI , 0.24-7.98) and IBD overall (pooled aHR = 1.89; 95% CI , 0.71-5.04). Children with overweight or obesity at age 3 had no increased risk of IBD compared to normal-weight children (pooled aHR = 1.15, 95% CI , 0.74-1.77; and 1.05, 95% CI , 0.43-2.58, respectively). Early-life BMI trajectories were not consistently associated with IBD.
Conclusion:
In this Scandinavian birth cohort, 7-8 year-old children with obesity had an increased risk of developing ulcerative colitis later in life. Given the high prevalence of childhood obesity, this observation should be corroborated and possible mechanisms behind the association clarified.
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