P1236 Temporal trends in obesity and its prognostic impact in Korean patients with inflammatory bowel disease
Authors: Hwang S W , Kim M K , Hong S W , Park S H , Yang D H , Ye B D , Byeon J S , Myung S J , Yang S K 
Published: January 2025

Abstract

Background
In recent decades, there has been an escalation in the prevalence of obese patients with Inflammatory Bowel Disease (IBD).1-3 In addition, the correlation between Body Mass Index (BMI) at the time of diagnosis and the prognostic implication shows controversial results. Our study aims to assess the changes in BMI among Korean patients with IBD over a 14-year period and to explore how BMI at diagnosis impacts prognosis.

Methods
We gathered data from patients diagnosed with IBD at Asan Medical Center, Korea, between 2008 and 2021 and analysed weight, height, and laboratory data. We calculated the median BMI and mean value of laboratory data for each year, using these results as representative values for the respective years. Also, patients assessed for BMI at the time of diagnosis were further analysed for intestinal resection-free and medication-free survival using the prospectively managed registry data.

Results
From January 2008 to December 2021, 11,216 patients with IBD, comprising 5,502 with Crohn's disease (CD) and 5,714 with ulcerative colitis (UC), accounted for 277,179 visits. The median BMI of included patients significantly increased over the study period, from 21.2 kg/m2 in 2008 to 23.0 kg/m2 in 2021 (p-value for trend &lt;0.001) This trend was more apparent in CD than UC, and male than female (Figure 1a, 1c) Over the years, the gap in the prevalence of obese (BMI ≥25 kg/m2) individuals between those with IBD and the general population has narrowed. (Figure 1b, 1d) Serum glucose and lipid profiles showed an upward trend during the study period. The odds of intestinal resection and the use of biologics or small molecules were comparable or even lower in CD patients who were obese at diagnosis compared to patients with a normal BMI. Obese patients with UC demonstrated a similar cumulative probability of using thiopurines and biologics or small molecules. Obesity was inversely associated with the risk of thiopurine use in CD patients (adjusted hazard ratio: 0.61, 95% confidence interval: 0.48–0.78, p&lt;0.001, Table 1)

Conclusion
During a 14-year period, Korean IBD patients showed increasing trends in the prevalence of obese individuals and metabolic syndrome-associated laboratory results. CD patients with high BMI at diagnosis exhibited a similar or lower likelihood of undergoing intestinal resection and medication use compared to those with a normal BMI. It is important to acknowledge the prevalence of obesity among patients with IBD and to give increased attention to the consequences associated with metabolic syndrome, as well as the clinical outcomes related to IBD.

References
1.Nic Suibhne T, Raftery TC, McMahon O, et al. High prevalence of overweight and obesity in adults with Crohn's disease: associations with disease and lifestyle factors. J Crohns Colitis. 2013;7:e241-8
2.Singh S, Dulai PS, Zarrinpar A, et al. Obesity in IBD: epidemiology, pathogenesis, disease course and treatment outcomes. Nat Rev Gastroenterol Hepatol. 2017;14:110-21
3.Seminerio JL, Koutroubakis IE, Ramos-Rivers C, et al. Impact of Obesity on the Management and Clinical Course of Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015;21:2857-63.