Tumor necrosis factor-α production in adipose tissue is well documented.
Crohn's disease patients with increased adipose tissue may have more severe disease.
Dr Gary Lichtenstein and colleagues from Pennsylvania evaluated 148 overweight patients with Crohn's disease.
The investigative team determined if the clinical course of these patients differ from those with a normal or low body mass index.
Patients at the Hospital of the University of Pennsylvania from 1997 to 2002 were included.
Data were collected from outpatient records and standardized interviews.
The team defined overweight as a body mass index (BMI) of 25 kg/m2 or higher.
|Time to first surgery was 24 months with a higher BMI vs 252 months with a lower BMI|
|Clinical Gastroenterology & Hepatology|
The primary outcome was time to first surgery.
Secondary outcomes included age at diagnosis, number of surgeries, and escalation of therapy.
The investigators compared 48 patients with a body mass index of 25 kg/m2 or higher at diagnosis with patients with a body mass index less than 25 kg/m2.
Survival analysis compared time to first surgery.
The team found that patients with a higher body mass were older at diagnosis compared with a body mass index of less than 25 kg/m2.
The number of surgeries, escalation of therapy, and disease distribution did not differ between the 2 groups.
The investigators observed a significant difference for time to first surgery.
For patients with a higher body mass index, time to first surgery was 24 months vs 252 months for patients with a body mass index of less than 19 kg/m2.
Dr Lichtenstein's team commented, “Crohn's disease patients with a body mass index of 25 kg/m2 or higher at diagnosis were older at diagnosis and had a shorter time to first surgery than those with a body mass index of less than 19 kg/m2.”
“This suggests that overweight Crohn's disease patients require earlier surgical intervention and perhaps more aggressive medical therapy.”