P1037 Prevalence and factors associated with obesity in patients with IBD treated with infliximab and vedolizumab across the United Kingdom (UK)
Authors: Roberts C , Hodges P , Badrulhisham F , Smith R , Vida C , Bewshea C , Kennedy N , Goodhand J , Ahmad T 
Published: January 2025

Background

Adipose tissue has a regulatory role in innate and adaptive immune processes and obesity has been linked to non-response to medical therapies and disease progression in patients with IBD1. Few studies have estimated the prevalence of obesity in patients with IBD in the UK and none have assessed associations with geographical determinants of health.

We sought to define in adult patients with IBD treated with infliximab and vedolizumab who were recruited to the UK CLARITY IBD2 study the:

1. Prevalence of overweight and obesity

2. Demographic, geographic and disease factors associated with obesity

3. Influence of obesity on mood and anxiety

4. Relationship between obesity and geographical determinants of health

Methods

Obesity was defined according to World Health Organisation body mass index (BMI) definitions for adults. Mood and anxiety disorders were assessed using the Patient Health Questionnaire (PHQ-8) and General Anxiety Disorder Assessment (GAD-7). We collapsed individual’s postcodes to Level Super Output Areas (England and Wales) and data zones (Scotland) and extracted income decile from the index of multiple deprivation. We extracted geographical determinants of health data from the Access to Healthy Assests and Hazards [AHAH] (Version 3)3. This index combines health indicators across four domains: retail environment, health services, the physical environment and air quality. Income decile was extracted from the index of multiple deprivation. Statistical analyses were undertaken comparing patients with obesity with those who were overweight or had a normal BMI. Multivariable analyses were restricted to patients living in England.

Results

Body mass index data were available in 98.3% (6664/7020) of adults. Overall, 31.9% (1685/6664 95% confidence interval [CI] 30.8-33.0) and 25.3% (1685/6664 95% CI 24.2-26.3) patients were overweight and obese, respectively. The highest prevalence of obesity was observed in the West Midlands and the lowest prevalence in London and Scotland (Figure 1).

Multivariable logistic regression analysis demonstrated that obesity was independently associated with female sex, older age, non-Asian ethnicity, non-smoking and active IBD (PRO-2). Obesity was associated with mild, moderate and severe depression but not anxiety. Obesity did not vary by urban or rural location. Obesity was significantly associated with higher deprivation scores but not the overall AHAH score. Factors associated with obesity are shown in Figure 2.

Conclusion

Obesity is common in UK patients living with IBD and is independently associated with female sex, older age, non-Asian ethnicity, geographical region, non-smoking, active IBD and deprivation.

References

1.Kennedy NA, et al. Predictors of anti-TNF treatment failure in anti-TNF-naive patients with active luminal Crohn’s disease: a prospective, multicentre, cohort study. Lancet Gastroenterol Hepatol. 2019 May;4(5):341-353. doi: 10.1016/S2468-1253(19)30012-3. Epub 2019 Feb 27. PMID: 30824404

2.Kennedy NA, Goodhand JR, Bewshea C Contributors to the CLARITY IBD study, et alAnti-SARS-CoV-2 antibody responses are attenuated in patients with IBD treated with infliximab. Gut 2021;70:865-875

3.Access to Healthy Assets & Hazards (AHAH) Version 3, Consumer Data Research Centre, Accessed 18th November 2024