Prevalence and Epidemiology of Overweight and Obesity in Children with Inflammatory Bowel Disease

University of North Carolina at Chapel Hill, Department of Medicine, Division of Gastroenterology and Hepatology, Chapel Hill, North Carolina 27599-7080, USA.
Inflammatory Bowel Diseases (Impact Factor: 4.46). 10/2011; 17(10):2162-8. DOI: 10.1002/ibd.21585
Source: PubMed


Obesity is a significant public health threat to children in the United States. The aims were to: 1) Determine the prevalence of obesity in a multicenter cohort of children with inflammatory bowel disease (IBD); 2) Evaluate whether overweight and obese status is associated with patient demographics or disease characteristics.
We used data from the ImproveCareNow Collaborative for pediatric IBD, a multicenter registry of children with IBD, collected between April 2007 and December 2009. Children ages 2-18 years were classified into body mass index (BMI) percentiles. Bivariate analyses and multivariate logistic regression were used to compare demographic and disease characteristics by overweight (BMI >85%) and obese (BMI >95%) status.
The population consisted of 1598 children with IBD. The prevalence of overweight/obese status in pediatric IBD is 23.6%, (20.0% for Crohn's disease [CD] and 30.1% for ulcerative colitis [UC] and indeterminate colitis [IC]). African American race (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.10-2.48) and Medicaid insurance (OR 1.67, 95% CI 1.19-2.34) were positively associated with overweight/obese status. Prior IBD-related surgery (OR 1.73, 95% CI 1.07-2.82) was also associated with overweight and obese status in children with CD. Other disease characteristics were not associated with overweight and obesity in children with IBD.
Approximately one in five children with CD and one in three with UC are overweight or obese. Rates of obesity in UC are comparable to the general population. Obese IBD patients may have a more severe disease course, as indicated by increased need for surgery. Sociodemographic risk factors for obesity in the IBD population are similar to those in the general population.

Download full-text


Available from: Hans Herfarth
  • Source
    • "Obesity occurs in IBD despite the strong association between IBD and growth retardation [24]. A recent study of nearly 1600 children reported an obesity rate of 20% in children with IBD; and a rate for overweight status that is similar to that of the general population at nearly 30% [25]. The control group in this study had a non-significantly higher BMI z-score than the subjects with IBD. "
    [Show abstract] [Hide abstract]
    ABSTRACT: CONTEXT: There is no consensus on the vitamin D status of children and adolescents with inflammatory bowel disease (IBD). AIM: To determine the vitamin D status of patients with IBD by comparing their serum 25(OH)D concentration to that of healthy controls. HYPOTHESIS: Serum 25(OH)D concentration will be lower in patients with IBD compared to controls. SUBJECTS AND METHODS: A case-controlled retrospective study of subjects with IBD (n = 58) of 2-20 years (male n = 31, age 16.38±2.21 years; female n = 27, age16.56±2.08 years) and healthy controls (n = 116; male n = 49, age 13.90±4.59 years; female n = 67, age 15.04±4.12years). Study subject inclusion criteria: diagnosis of Crohn's disease (CD) or ulcerative colitis (UC). Vitamin D deficiency was defined as 25(OH)D of (/mL) (/L), overweight as BMI of ≥85th butpercentile, and obesity as BMI ≥95th percentile. Data were expressed as mean ± SD. RESULTS: Patients with CD, UC, and their controls had mean serum 25(OH)D concentrations of 61.69±24.43 nmol/L, 53.26±25.51, and 65.32±27.97 respectively (ANOVA, p = 0.196). The overweight/obese controls had significantly lower 25(OH)D concentration compared to the normal-weight controls (p = 0.031); whereas 25(OH)D concentration was similar between the normal-weight and overweight/obese IBD patients (p = 0.883). There was no difference in 25(OH)D between patients with UC and CD, or between subjects with active IBD and controls. However, IBD subjects with elevated ESR had significantly lower 25(OH)D than IBD subjects with normal ESR (p = 0.025), as well as controls (65.3±28.0 nmol/L vs. 49.5±25.23, p = 0.045). CONCLUSION: There is no difference in mean serum 25(OH)D concentration between children and adolescents with IBD and controls. However, IBD subjects with elevated ESR have significantly lower 25(OH)D than controls. Therefore, IBD subjects with elevated ESR should be monitored for vitamin D deficiency.
    Full-text · Article · Jul 2014 · PLoS ONE
  • Source
    • "Inflammatory bowel disease (IBD) is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract. It has shown a steep rise in incidence and is now one of the five most prevalent gastrointestinal diseases in the U.S. (Long et al., 2011). IBD has been reported to have an overall prevalence of 16.6 cases per 100,000 children and 5.3 cases per 100,000 children younger than 16 years old. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Artemisinin has been used to treat malaria for centuries in the context of traditional Chinese medicine. In the present study, the effects of artemisinin on pregnane X receptor (PXR)-mediated CYP3A expression and its therapeutic role in inflammatory bowel disease were investigated. LS174T cells exposed to artemisinin at various concentrations and for different periods of time were examined with respect to the specific induction of CYP3A4 and PXR mRNA expression. Transient transfection experiments showed transcriptional activation of the CYP3A4 gene through artemisinin to be PXR-dependent. An electrophoretic-mobility shift assay (EMSA) showed that artemisinin activates the DNA-binding capacity of the PXR for the CYP3A4 element. These results indicate that the induction of CYP3A4 by artemisinin is mediated through the activation of PXR. Using animal models, it was demonstrated that artemisinin abrogates dextran sulfate sodium (DDS)-induced intestinal inflammation. Preadministration of artemisinin ameliorated the clinical hallmarks of colitis in DSS-treated mice as determined by body weight loss and assessment of diarrhea, rectal bleeding, colon length, and histology. Artemisinin was found to prevent or reduce the severity of colonic inflammation by inducing CYP3A expression by activation of PXR.
    Full-text · Article · May 2014 · European Journal of Pharmacology
  • Source
    • "Parallel to the progression of industrialization and coinciding with a high prevalence of obesity and associated metabolic disorders, the incidence of IBD has risen considerably over the last decades. Although IBD patients have historically been lean and even malnourished due to inflammation-associated malabsorption, recent studies report increasing rates of overweight IBD patients [1], [2], and associate obesity with a more severe disease course [1], [3]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Obesity has been associated with a more severe disease course in inflammatory bowel disease (IBD) and epidemiological data identified dietary fats but not obesity as risk factors for the development of IBD. Crohn’s disease is one of the two major IBD phenotypes and mostly affects the terminal ileum. Despite recent observations that high fat diets (HFD) impair intestinal barrier functions and drive pathobiont selection relevant for chronic inflammation in the colon, mechanisms of high fat diets in the pathogenesis of Crohn’s disease are not known. The aim of this study was to characterize the effect of HFD on the development of chronic ileal inflammation in a murine model of Crohn’s disease-like ileitis.
    Full-text · Article · Aug 2013 · PLoS ONE
Show more