Pathomorphosis of ulcerative colitis: from body weight deficiency to sarcopenic obesity
https://doi.org/10.31146/1682-8658-ecg-218-10-57-62
Abstract
In recent decades, there has been a steady increase in the number of patients with non-communicable chronic diseases in developed economic countries, which include all nosologies of metabolic syndrome and chronic inflammatory diseases. To date, there is no doubt that pro-inflammatory pathogenetic mechanisms and changes in intestinal microbiocenosis associated with obesity are promoters of many non-communicable diseases. The “Westernized” style of nutrition influences the intraspecific qualitative and quantitative diversity of the intestinal microbiome, leading to a change in the permeability of the intestinal barrier and triggering an immune response. Recent studies show that about 15-40 % of patients with inflammatory bowel diseases (IBD) are obese, and another 20-40 % are overweight. The coexistence of inflammation, obesity and metabolic syndrome in patients with ulcerative colitis is becoming more and more frequent, meanwhile, there is a discrepancy between the severity of the disease and weight indicators, which may be unchanged and even exceed the norm. The effects associated with sarcopenia and sarcopenic obesity negatively affect the quality of life of patients with ulcerative colitis and long-term results. Sarcopenia acts as an independent predictor of surgical interventions in patients with IBD, is associated with high activity of the disease and with a higher frequency of postoperative complications, and is also a marker of the need for escalation of therapy. The general mechanisms of development indicate that the management of these conditions should be considered in a complex.
About the Authors
G. R. Bikbavova
Omsk State Medical University
Russian Federation
Russian Federation
M. A. Livzan
Omsk State Medical University
Russian Federation
Russian Federation
N. S. Lisyutenko
Omsk State Medical University
Russian Federation
Russian Federation
A. E. Romanyuk
Omsk State Medical University
Russian Federation
Russian Federation
References
1. Shelygin Yu.A., Ivashkin V. T., Belousova E. A. et al. Ulcerative colitis (K51), adults. Koloproktologia. 2023;22(1):10-44. (In Russ.) doi: 10.33878/2073-7556-2023-22-1-10-44.@@ Шелыгин Ю. А., Ивашкин В. Т., Белоусова Е. А., и др. Язвенный колит (К51), взрослые. Колопроктология. 2023;22(1):10-44. doi: 10.33878/2073-7556-2023-22-1-10-44.
2. Wallace K. L., Zheng L. B., Kanazawa Y., Shih D. Q. Immunopathology of inflammatory bowel disease. World J Gastroenterol. 2014;20(1):6-21. doi: 10.3748/wjg.v20.i1.6.
3. Sheehan D., Shanahan F.The Gut Microbiota in Inflammatory Bowel Disease. Gastroenterol Clin North Am. 2017;46(1):143-154. doi: 10.1016/j.gtc.2016.09.011.
4. Makeykina M. A., Livzan M. A. Genetic prognostic factors for the course of non-specific ulcerative colitis. Practical medicine. 2012;9(65):133-136. (In Russ.)@@ Макейкина М.А., Ливзан М. А. Генетические прогностические факторы течения неспецифического язвенного колита. Практическая медицина. 2012; 9(65):133-136.
5. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol. 2020;5(1):17-30. doi: 10.1016/S2468-1253(19)30333-4.
6. Kaplan G. G., Ng S. C. Understanding and preventing the global increase of inflammatory bowel disease. Gastroenterology. 2017;152(2):313-321.e2. doi: 10.1053/j.gastro.2016.10.020.
7. Hou, J.K., Abraham B., El-Serag H. Dietary intake and risk of developing inflammatory bowel disease: A systematic review of the literature. Am J Gastroenterol. 2011;106(4):563-573. doi: 10.1038/ajg.2011.44.
8. Bischoff S. C., Barazzoni R., Busetto L. et al. European guideline on obesity care in patients with gastrointestinal and liver diseases e Joint ESPEN/UEG guideline. Clinical Nutrition. 2022;41(10):2364-2405. doi: 10.1016/j.clnu.2022.07.003.
9. Gentile C. L., Weir T. L. The gut microbiota at the intersection of diet and human health. Science. 2018;362(6416):776-780. doi: 10.1126/science.aau5812.
10. Blaser M. J., Falkow S. What are the consequences of the disappearing human microbiota? Nat Rev Microbiol. 2009;7(12):887-894. doi: 10.1038/nrmicro2245.
11. Dong J., Chen Y., Tang Y., et al. Body mass index is associated with inflammatory bowel disease: A systematic review and meta-analysis. PLoS One. 2015;10(12): e0144872. doi: 10.1371/journal.pone.0144872.
12. Maev I. V., Shelygin Yu.A., Skalinskaya M. I. et al. The pathomorphosis of inflammatory bowel diseases. Annals of the Russian Academy of Medical Sciences. 2020;75(1):27-35. (In Russ.) doi: 15690/vramn1219.@@ Маев И. В., Шелыгин Ю. А., Скалинская М. И., и др. Патоморфоз воспалительных заболеваний кишечника. Вестник РАМН. 2020;75(1):27-35. doi: 15690/vramn1219
13. Bikbavova G. R., Livzan M. A., Lisyutenko N. S. et al. Prevalence of overweight and obesity in patients with ulcerative colitis: a case-control study. Experimental and Clinical Gastroenterology. 2023;(4):6-11. (In Russ.) doi: 10.31146/1682-8658-ecg-212-4-6-11.@@ Бикбавова Г. Р., Ливзан М. А., Лисютенко Н. С. и др. Распространенность избыточной массы тела и ожирения у больных язвенным колитом: исследование случай-контроль. Экспериментальная и клиническая гастроэнтерология. 2023;4:6-11. doi: 10.31146/1682-8658-ecg-212-4-6-11.
14. Johnson A. M., Loftus E. V. Obesity in inflammatory bowel disease: A review of its role in the pathogenesis, natural history, and treatment of IBD. Saudi J Gastroenterol. 2021;27(4):183-190. doi: 10.4103/sjg.sjg_30_21.
15. Garvey W. T., Garber A. J., Mechanick J. I. et al. On behalf of the AACE obesity scientific C. American association of clinical endocrinologists and american college of endocrinology position statement on the 2014 advanced framework for a new diagnosis of obesity as a chronic disease. Endocr Pract. 2014;20(9):977-989. doi: 10.4158/EP14280.PS.
16. Versini M., Jeandel P. Y., Rosenthal E. et al. Obesity in autoimmune diseases: Not a passive bystander. Autoimmunity Rev. 2014;13(9):981-1000. doi: 10.1016/j. autrev.2014.07.001.
17. Kinlen D., Cody D., O’Shea D.Complications of obesity. QJM. 2018;111(7):437-443. doi: 10.1093/qjmed/hcx152.
18. Khakoo N. S., Ioannou S., Khakoo N. S. et al. Impact of Obesity on Inflammatory Bowel Disease. Curr Gastroenterol Rep. 2022;24(1):26-6. doi: 10.1007/s11894-022-00840-x.
19. Livzan M. A., Krolevets T. S., Lapteva I. V., Cherkashchenko N. A. Non-alcoholic fatty liver disease in persons with abdominal type of obesity.Russian Journal of Evidence-Based Gastroenterology. 2014;3(4):8-14. (In Russ.) doi: 10.17116/dokgastro2014348-14. @@ Ливзан М. А., Кролевец Т. С., Лаптева И. В., Черкащенко Н. А. Неалкогольная жировая болезнь печени у лиц с абдоминальным типом ожирения. Доказательная гастроэнтерология. 2014;3(4):8-14. doi: 10.17116/dokgastro2014348-14.
20. Yorulmaz E., Adali G., Yorulmaz H. et al. Metabolic syndrome frequency in inflammatory bowel diseases. Saudi J. Gastroenterol. 2011;17(6):376-82. doi: 10.4103/1319-3767.87177.
21. Zamani M., Alizadeh-Tabari S., Singh S. et al. Meta-analysis: Prevalence of, and risk factors for, non-alcoholic fatty liver disease in patients with inflammatory bowel disease. Aliment. Pharmacol. Ther. 2022;55(8):894-907. doi: 10.1111/apt.16879.
22. Noorian S., Jeon Y., Nguyen M. T. et al. The Impact of NAFLD on Hospitalization Outcomes in Patients with Inflammatory Bowel Diseases: Nationwide Analysis. Inflamm. Bowel Dis. 2022;28(6):878-887. doi: 10.1093/ibd/izab199.
23. Lees C. W., Barrett J. C., Parkes M., Satsangi J. New IBD genetics: Common pathways with other diseases. Gut. 2011;60(12:1739-1753. doi: 10.1136/gut.2009.199679.
24. Sang M. M., Sun Z. L., Wu T. Z. Inflammatory bowel disease and diabetes: Is there a link between them? World J Diabetes. 2022;13(2):126-128. doi: 10.4239/wjd. v13.i2.126.
25. Rodriguez-Duque J. C., Calleja J. L., Iruzubieta P. et al. Increased risk of MAFLD and Liver Fibrosis in Inflammatory Bowel Disease Independent of Classic Metabolic Risk Factors. Clin. Gastroenterol. Hepatol. 2023;21(2):406-414.e7. doi: 10.1016/j.cgh.2022.01.039.
26. Aniwan S., Pardi D. S., Tremaine W. J., Loftus E. V. Jr. Increased risk of acute myocardial infarction and heart failure in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol. 2018;16(10):1607-1615.e1. doi: 10.1016/j.cgh.2018.04.031.
27. Panhwar M. S., Mansoor E., Al-Kindi S. G. et al. Risk of myocardial infarction in inflammatory bowel disease: a population-based national study. Inflam Bowel Dis. 2019;25(6):1080-1087. doi: 10.1093/ibd/izy354.
28. Rungoe C., Basit S., Ranthe M. F. et al. Risk of ischaemic heart disease in patients with inflammatory bowel disease: a nationwide Danish cohort study. Gut. 2013;62(5):689-694. doi: 10.1136/gutjnl-2012-30328.
29. Adolph T. E., Meyer M., Schwärzler J. et al. The metabolic nature of inflammatory bowel diseases. Nat Rev Gastroenterol Hepatol. 2022;19(12):753-767. doi: 10.1038/s41575-022-00658-y.
30. O’Grady J., Shanahan F. Changing phenotype of inflammatory bowel disease and neglected metabolic health. Cogent Medicine. 2021;8(1):918318. doi: 10.1080/2331205X.2021.1918318.
31. Cederholm T., Barazzoni R., Austin P. et al. ESPEN guidelines on defifinitions and terminology of clinical nutrition. Clin Nutr. 2017;36(1):49-64. doi: 10.1016/j.clnu.2016.09.004.
32. Nishikawa H., Nakamura S., Miyazaki T. et al. Inflammatory bowel disease and sarcopenia: its mechanism and clinical importance. J Clin Med. 2021;10(18):4214. doi: 10.3390/jcm10184214.
33. Fatani H., Olaru A., Stevenson R. et al. Systematic review of sarcopenia in inflammatory bowel disease. Clin Nutr. 2023;42(8):1276-1291. doi: 10.1016/j.clnu.2023.05.002.
34. Ge X., Jiang L., Yu W. et al. The importance of sarcopenia as a prognostic predictor of the clinical course in acute severe ulcerative colitis patients. Dig Liver Dis. 2021;53(8):965-971. doi: 10.1016/j.dld.2021.03.031.
35. Pedersen M., Cromwell J., Nau P. Sarcopenia is a predictor of surgical morbidity in inflammatory bowel disease. Inflamm Bowel Dis. 2017;23(10):1867-1872. doi: 10.1097/MIB.0000000000001166.
36. Cushing K. C., Kordbacheh H., Gee M. S., et al. Sarcopenia is a novel predictor of the need for rescue therapy in hospitalized ulcerative colitis patients. J Crohns Colitis. 2018;12(9):1036-1041. doi: 10.1093/ecco-jcc/jjy064.
37. Adams D. W., Gurwara S., Silver H. J. et al. Sarcopenia is common in overweight patients with inflammatory bowel disease and may predict need for surgery. Inflamm Bowel Dis. 2017;23(7):1182-1186. doi: 10.1097/MIB.0000000000001128.
38. Liu S., Ding X., Maggiore G. et al. Sarcopenia is associated with poor clinical outcomes in patients with inflammatory bowel disease: a prospective cohort study. Ann Transl Med. 2022;10(6):367. doi: 10.21037/atm-22-1126.
Review
For citations:
Bikbavova G.R., Livzan M.A., Lisyutenko N.S., Romanyuk A.E. Pathomorphosis of ulcerative colitis: from body weight deficiency to sarcopenic obesity. Experimental and Clinical Gastroenterology. 2023;(10):57-62. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-218-10-57-62
Views:
145
Email this article 