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Review

Impact of Body Mass Index on the Development of Inflammatory Bowel Disease: A Systematic Review and Dose-Response Analysis of 15.6 Million Participants

1
Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Univerziti Kralova, 500 03 Hradec Kralova, Czech Republic
2
Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
3
Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran
4
Division of Occupational Medicine, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada
5
Occupational Medicine Clinic, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5C 2C5, Canada
*
Author to whom correspondence should be addressed.
Healthcare 2021, 9(1), 35; https://doi.org/10.3390/healthcare9010035
Received: 4 December 2020 / Revised: 24 December 2020 / Accepted: 30 December 2020 / Published: 3 January 2021
(This article belongs to the Section Nutrition and Public Health)
Background: A growing trove of literature describes the effect of malnutrition and underweight on the incidence of inflammatory bowel disease (IBD). However, evidence regarding the association between underweight or obesity and IBD is limited. The study aimed to assess the association of body mass index (BMI) with a risk of IBD (Crohn’s disease (CD) and ulcerative colitis (U.C.)) incidence. Methods: We systematically searched PubMed/Medline, Cochrane, Web of Science, and Scopus for observational studies assessing the association between BMI and IBD that were published up to 30 June 2020. We estimated pooled hazard ratios (HR) with corresponding 95% confidence intervals (CI). Random effect dose-response meta-analysis was performed using the variance weighted least-squares regression (VWLS) models to identify non-linear associations. Results: A total of ten studies involving 15.6 million individuals and 23,371 cases of IBD were included. Overall, obesity was associated with an increased IBD risk (HR: 1.20, 95% CI: 1.08–1.34, I2 = 0%). Compared to normal weight, underweight (BMI < 18.5 kg/m2) and obesity (BMI ≥ 30 kg/m2) were associated with a higher risk of CD, and there was no difference in the risk of U.C. among those with BMI < 18.5 kg/m2 and BMI ≥ 30 kg/m2. There was a significant non-linear association between being underweight and obesity and the risk of development of CD (Coef1 = −0.0902, p1 < 0.001 Coef2 = 0.0713, p2 < 0.001). Conclusions: Obesity increases the risk of IBD development. Underweight and obesity are independently associated with an increased risk of CD, yet there is no evident association between BMI and the risk of U.C. Further studies are needed to clarify the underlying mechanism for these findings, particularly in CD. View Full-Text
Keywords: obesity; body mass index; inflammatory bowel disease; Crohn’s disease; systematic review; meta-analysis; dose-response analysis obesity; body mass index; inflammatory bowel disease; Crohn’s disease; systematic review; meta-analysis; dose-response analysis
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MDPI and ACS Style

Bhagavathula, A.S.; Clark, C.C.T.; Rahmani, J.; Chattu, V.K. Impact of Body Mass Index on the Development of Inflammatory Bowel Disease: A Systematic Review and Dose-Response Analysis of 15.6 Million Participants. Healthcare 2021, 9, 35. https://doi.org/10.3390/healthcare9010035

AMA Style

Bhagavathula AS, Clark CCT, Rahmani J, Chattu VK. Impact of Body Mass Index on the Development of Inflammatory Bowel Disease: A Systematic Review and Dose-Response Analysis of 15.6 Million Participants. Healthcare. 2021; 9(1):35. https://doi.org/10.3390/healthcare9010035

Chicago/Turabian Style

Bhagavathula, Akshaya S., Cain C.T. Clark, Jamal Rahmani, and Vijay K. Chattu. 2021. "Impact of Body Mass Index on the Development of Inflammatory Bowel Disease: A Systematic Review and Dose-Response Analysis of 15.6 Million Participants" Healthcare 9, no. 1: 35. https://doi.org/10.3390/healthcare9010035

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