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Higher Belly Fat Percentage Tied to Worse Outcomes for IBD Patients

Patients with higher intra-abdominal visceral adipose tissue percentage less likely to achieve corticosteroid-free deep remission or endoscopic remission

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Aug. 2, 2023 (HealthDay News) — For patients with inflammatory bowel disease (IBD), higher intra-abdominal visceral adipose tissue (IA-VAT) as a percentage of total body mass is associated with worse outcomes and may increase resistance to biologic drug therapy, according to a study published online July 25 in Gastroenterology.

Andres J. Yarur, M.D., from Cedars Sinai Medical Center in Los Angeles, and colleagues enrolled indivduals with active IBD initiating infliximab, vedolizumab, or ustekinumab and a healthy control group to examine the association between IA-VAT and response. The primary outcome was corticosteroid-free deep remission (SFDR) at weeks 14 to 16; secondary outcomes were SFDR and endoscopic remission at weeks 30 to 46. Data were included for 141 IBD patients and 51 healthy controls. Body composition parameters did not differ between the IBD and healthy control cohorts.

The researchers found that compared with patients with a lower IA-VAT percentage, those with a higher IA-VAT percentage were less likely to achieve SFDR or endoscopic remission. Significantly higher serum interleukin-6 and tumor necrosis factor at baseline were seen for nonresponders with high IA-VAT percentage compared with responders and patients with low IA-VAT percentage. When comparing high and low IA-VAT percentage groups, drug pharmacokinetics and microbiota diversity were similar.

“We found that higher visceral adiposity was associated with higher levels of proinflammatory cytokines, suggesting that fat tissue promotes inflammation, the opposite of what we want, and increases resistance to biologic drug therapy,” coauthor Gil Y. Melmed, M.D., also from Cedars-Sinai, said in a statement. “More research is needed because we don’t know whether lowering visceral fat or giving higher doses of the medications would improve drug efficacy.”

Several authors disclosed ties to the biopharmaceutical industry.

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