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Visceral adiposity and inflammatory bowel disease

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Rates of obesity are increasing worldwide, as is the incidence of inflammatory bowel disease (IBD). Obesity is now considered an inflammatory state. Visceral adiposity in particular may be associated with a more severe inflammatory phenotype in IBD.

Aim

The aim of this review article is to summarise the current literature on the association between visceral adiposity and outcomes in inflammatory bowel disease

Methods

To collect relevant articles, PubMed/MEDLINE and Embase searches were performed using Boolean search phrases. Grey literature and manual searches were also performed. Abstracts were selected by two independent reviewers based on pre-determined criteria. Full text articles were reviewed, and data extracted and assessed.

Results

One hundred twenty-seven abstracts were obtained through the initial search, with 85 abstracts reviewed and 22 full text articles included. Characteristics are included in Table 1. Most of these were retrospective studies and of moderate or weak quality. Studies suggested visceral fat content is higher in Crohn’s disease than in healthy controls. Visceral adiposity was associated with an increased risk of complex Crohn’s disease phenotype (OR 26.1 95% CI 2–75.4; p = 0.02). Post-operative recurrence was higher in patients with higher visceral fat indices (RR 2.1; CI 1.5–3; p = 0.012). There were conflicting data regarding the effect of visceral adiposity on post-operative complications and the efficacy of medical therapy.

Table 1 Study characteristics
Full size table

Conclusion

Visceral adiposity appears to be increased in Crohn’s disease with some evidence that it is also associated with more complex disease phenotypes. There is also a signal that post-operative recurrence rates are affected by increasing mesenteric adiposity. There is a relative lack of data in UC patients and further high-quality studies are necessary to elucidate the relationship between visceral adiposity and IBD and the implications for patient outcomes.

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Acknowledgements

This study is a collaborative effort, and the authors would like to acknowledge all those who contributed. Specifically, Catherine Rowan and Aoibhlinn O’Toole were involved in the conception of the study. Catherine Rowan and John McManus carried out the literature search and review. Catherine Rowan and Aoibhlinn O’Toole drafted the report. John McManus and Karen Boland assisted in editing the final draft of the manuscript.

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Authors and Affiliations

  1. Department of Gastroenterology, Beaumont Hospital, Beaumont Rd, Dublin, Ireland

    Catherine R. Rowan, John McManus, Karen Boland & Aoibhlinn O’Toole

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  1. Catherine R. Rowan
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  4. Aoibhlinn O’Toole
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Correspondence to Catherine R. Rowan.

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Rowan, C.R., McManus, J., Boland, K. et al. Visceral adiposity and inflammatory bowel disease. Int J Colorectal Dis 36, 2305–2319 (2021). https://doi.org/10.1007/s00384-021-03968-w

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