P2149 - Obesity Is Associated With Lower Prevalence of Complications in Crohn’s Disease: A Global Healthcare Database Study

Mengdan Xie, MD¹, Marc Landsman, MD², Nisheet Waghray, MD³, Gengqing Song, MD^2
1MetroHealth Medical Center, Cleveland, OH; ²MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH; ³Case Western Reserve University/Metro Health, Cleveland, OH

Introduction: The prevalence of obesity within Crohn’s disease has been rising in the past decades, however, the data about the impact of obesity on Crohn’s activity and course were conflicting. Our study aimed to reveal the association between obesity and Crohn’s complications.

Methods: We conducted a population-based, retrospective cohort study utilizing TriNetX electronic health records network. The obese cohort comprised patients with body mass index (BMI) of more than 30 kg/m2, while the non-obese cohort included patients with normal BMI. 1:1 propensity score matching was performed to reduce confounding factors. The primary outcome was the occurrence of Crohn’s related complications, including obstruction, fistula, abscess, rectal bleeding. Prevalence of other Crohn related disorders, hospitalization, abdominal surgery, medication use, and death were also analyzed.

Results: A total of 15850 patients with Crohn’s disease were included in obese and non-obese groups, respectively, after propensity score matching. Compared to the non-obese group, Crohn’s patients with concurrent obesity had a significantly lower risk of all kinds of Crohn’s complications (OR 0.66, 95%CI 0.63-0.7 for any complications; 0.66, 0.61-0.71 for fistula; 0.52, 0.48-0.56 for bowel obstruction; 0.51, 0.45-0.57 for abscess; 0.78, 0.72-0.85 for rectal bleeding). There was a lower rate of surgical procedures of the intestine, colon, rectum, and anus in the obese group (0.77, 73-81). Primary sclerosing cholangitis (0.58, 0.46-0.72) and osteoporosis (0.6, 0.57-0.64) were less prevalent in obese patients with Crohn’s disease. There was no significant difference in incidence of skin manifestation, eye manifestation, vitamin D deficiency, or thromboembolism event between the two groups. In parallel with the lower incidence of Crohn's complications in the obese group, there was a lower incidence of biologics usage in this group (0.76, 0.72-0.8). Despite the higher prevalence of comorbidities, including diabetes, hypertension, heart failure, ischemic heart disease, stroke, chronic lung disease, and chronic kidney disease in the obese group compared to non-obese at baseline, obese patients with Crohn’s disease had slightly lower rates of hospitalization (0.95, 0.9-0.99) and lower mortality (0.73, 0.66-0.81).

Discussion: Obesity was associated with decreased prevalence of complications, biologics use, hospitalization, and mortality in Crohn’s disease, which may be suggestive of lower disease activity and better clinical outcomes.



Disclosures:


Mengdan Xie, MD¹, Marc Landsman, MD², Nisheet Waghray, MD³, Gengqing Song, MD². P2149 - Obesity Is Associated With Lower Prevalence of Complications in Crohn’s Disease: A Global Healthcare Database Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.