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Published on: September 22, 2019
Mortality risk associated with general and central obesity in inflammatory bowel disease patients: a long-term
Qian Zhang1, Yutao Wang1, Si Liu1
1Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Disease, Beijing Key Laboratory of Early Gastrointestinal Cancer Medicine and Medical Devices, Beijing, China.
Aim:
To comprehensively investigate the long-term risk of all-cause mortality associated with general and central obesity in patients with inflammatory bowel disease (IBD).
Methods:
Overall, 5107 IBD patients [mean age 57.0 (SD: 8.0) years; 51.7% female] were included in the prospective cohort. General obesity was assessed using body mass index (BMI), while central obesity was evaluated using hip circumference, waist circumference (WC), waist-to-hip ratio (WHR), weight-adjusted waist index (WWI), conicity index (CI) and A Body Shape Index (ABSI). Primary outcome was all-cause death. Cox proportional hazards models were employed to examine the associations.
Results:
During a median of 14.6 years' follow-up, 591 all-cause deaths occurred. At baseline, 1681(32.9%), 2229(43.6%), 1161(22.7%) and 36(0.70%) patients were BMI-defined normal, overweight, obesity and underweight. Underweight individuals had a 2.22-fold increased mortality risk than those with normal BMI (HR = 3.22, 95% CI:1.70-6.11), while null associations were observed for overweight or obesity. As for central obesity, individuals with the highest quartiles of WC (HR = 1.34, 1.02-1.76), WHR (HR = 1.56, 1.13-2.15), WWI (HR = 1.64, 1.24-2.16), CI (HR = 1.72, 1.28-2.30) and ABSI (HR = 1.64, 1.23-2.20) had a 34%, 56%, 64%, 72% and 64% greater mortality risk versus the lowest quartiles, with significant dose-response relationships (all P values < 0.05).
Conclusions:
Central obesity and underweight, rather than general obesity, are associated with an increased risk of all-cause mortality in IBD patients. These findings underscore the importance of adequate nutrition and reduced visceral adiposity for long-term prognosis improvement of IBD patients.
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