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Region Hovedstaden - en del af Københavns Universitetshospital
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Relation of body mass index to risk of developing inflammatory bowel disease amongst women in the Danish National Birth Cohort

Publikation: Forskning - peer reviewTidsskriftartikel

DOI

  • Michael Mendall
  • Maria Christina Harpsøe
  • Devinder Kumar
  • Mikael Andersson
  • Tine Jess
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BACKGROUND: Crohn's disease (CD) has traditionally been associated with weight loss and low BMI, yet paradoxically obesity has recently been suggested as a risk factor for CD, but not for ulcerative colitis (UC). We therefore hypothesized that the relation between BMI and CD is U shaped.

AIM: To conduct a large population-based prospective cohort study of BMI and later risk of IBD, taking age at IBD diagnosis into account.

METHODS: A cohort of 74,512 women from the Danish National Birth Cohort, with BMI measured pre-pregnancy and 18 months after delivery, was followed for 1,022,250 person-years for development of IBD, according to the Danish National Patient Register. Associations were tested by Cox regression.

RESULTS: Overweight subjects (25≤BMI<30 kg/m2) had the lowest risk of CD, whereas obesity (BMI≥30kg/m2) increased the risk of CD at all ages, and low BMI (BMI<18.5kg/m2) associated with CD diagnosed at age 18-<40 years. Hence, using normal weight subjects as the reference, adjusted HRs for risk of developing CD (at age 18-<40 years) were 1.8(95%CI, 0.9-3.7) for underweight, 0.6(0.3-1.2) for overweight, and 1.5(0.8-2.7) for obese individuals (pre-pregnancy BMI). HRs were greater for BMI determined 18 months after delivery. Splines for CD risk according to waist:height ratio confirmed a U-shaped relationship with CD occurring <40 years, and a linear relationship with CD diagnosed at age 40+. There was no relationship between BMI and risk of UC.

CONCLUSION: For the first time, we demonstrate that both high BMI and low BMI are risk factors for CD. Underweight may be a pre-clinical manifestation of disease being present many years before onset with obesity being a true risk factor. This raises the question as to whether there may be two distinct forms of CD.

OriginalsprogEngelsk
TidsskriftP L o S One
Vol/bind13
Tidsskriftsnummer1
Sider (fra-til)e0190600
ISSN1932-6203
DOI
StatusUdgivet - 24 jan. 2018

ID: 52654327