P211 - IMPACT OF OBESITY ON FUTURE IBD-RELATED COMPLICATIONS IN A POPULATION-BASED COHORT OF CROHN’S DISEASE (CD) AND ULCERATIVE COLITIS (UC) PATIENTS
Friday, January 19, 2018: 5:30 PM - 7:00 PM
Introduction: Obesity is known to increase morbidity and mortality in a number of chronic conditions. As a proposed risk factor for adverse outcomes in inflammatory bowel disease (IBD), we aimed to review differences in IBD-related complications stratified by body mass index (BMI) in a population-based cohort of IBD patients. Methods: Utilizing the Rochester Epidemiology Project, we identified patients diagnosed with IBD from 1990 to 2010. Medical records were reviewed for BMI at diagnosis and future IBD-related complications. Outcomes were analyzed using Kaplan-Meier technique and univariate Cox models, with BMI as either a categorical or continuous variable, adjusting for age, sex, disease phenotype, and severity. Results: A total of 509 patients were diagnosed with IBD from 1990 to 2010, of whom 488 had BMI data available, including 221 CD (45.3%) and 267 UC (54.7%) patients. The prevalence of overweight and obesity at diagnosis was 32.4% and 24%, respectively. There were significant differences in the risk of surgery for CD (p=0.01) and UC (p=0.03) patients with BMI as a continuous variable. With each incremental increase in BMI, CD patients had a 5% decreased risk (HR 0.95; 95% CI 0.91-0.99), while UC patients saw a 6% increased risk of surgery (HR 1.06; 95% CI 1.01-1.12)(Table 1). UC patients also had a 3.4% higher risk of hospitalization with each increase in BMI (p=0.052). No differences were noted in time to steroid use for either group, nor for time to fistula or stricture notation in the CD patients. BMI categorically did not demonstrate significant differences (Figure 1). Conclusion: Within a population-based IBD cohort, increased BMI at diagnosis was protective in CD and a risk factor in UC when considering future risk for bowel resection. As obesity becomes more prevalent within the IBD population, further investigation into how it affects the natural history of IBD will help us better counsel and risk-stratify our patients at the time of diagnosis.
AuthorsAmanda M. Lynn(1), William S. Harmsen(2), William Tremaine(1), Barham Abu Dayyeh(1), Fateh Bazerbachi(1), Edward V Loftus Jr,(1)
Institutions1)Mayo Clinic, Gastroenterology and Hepatology; 2)Mayo Clinic, Biostatistics and Informatics