P-043 YI Phenotypic Differences in Obese Patients With Crohn’s Disease
Bibliographic record
Abstract
Crohn’s disease (CD) is a chronic inflammatory condition associated with nutritional risk secondary to decreased oral intake, hypermetabolism and reduced absorption. Conversely, the incidence of obesity worldwide is increasing and the effect of obesity on patients with CD is unknown. We aim to identify traits related to obesity in a cohort of patients with CD. This is a retrospective chart review of 209 consecutive adult patients with confirmed CD seen in our clinic from July 2011 to June 2013. Age, Montreal disease classification, sex, race, duration of disease, Harvey Bradshaw Index (HBI), Short Inflammatory Bowel Disease Questionnaire (SIBDQ) scores, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, physician global assessment, endoscopic appearance, histologic activity, medication use, and body mass index (BMI) data were collected about each patient. One-way ANOVA, Chi-square test and Logistic Regression were used to analyze the data. The mean age was 43.4 ± 14.9 years; 68.9% were Caucasian, and 51.7% were male. The mean duration of disease was 11.0 ± 10.6 years. The mean BMI was 26.8 ± 5.7: underweight (BMI < 20) 7.7%; normal weight (BMI 20–24) 29.3%; overweight (BMI > 25) 38.0%; and obese (BMI > 30) 25%. There were no significant differences among the BMI groups in race (P = 0.228) or gender (P = 0.441). Patients with ileocolonic disease were less likely to be obese or overweight than those with isolated ileal or isolated colonic disease (55.5% versus 68.6% or 75%, P = 0.021). Patients with higher BMI were more likely to have extra-intestinal manifestations (EIM) (underweight 6.3%, normal weight 9.8%, overweight 20%, obese 34.6%, P = 0.005). Patients with non-arthralgia EIMs had a higher BMI than those without such EIMs (29.9 ± 7.2 versus 26.4 ± 5.3, P = 0.004). There was a linear trend with rising BMI and non-arthralgia EIMs (underweight 6.3%, normal weight 3.3%, overweight 13.8%, obese 19.2%, P = 0.010). There was no correlation between duration of disease and BMI (P = 0.670). There was no significant difference in BMI between patients with inflammatory, fibrostenotic or penetrating disease (P = 0.951). There was a linear association between proximal CD and decreasing BMI (underweight 31.3%, normal weight 14.8%, overweight 15.0%, obese 7.7%; P = 0.046). There was no difference in BMI between patients with and without perianal disease (P = 0.216). The majority of patients in our cohort were overweight or obese, which correlates with national trends. Our data demonstrates that extensive disease location—but not disease behavior, duration, or activity—plays a role in weight modulation in CD patients. The linear association with low BMI and upper-tract disease modifier is most likely due to decreased oral intake in these patients due to post prandial pain or early satiety. Increased EIMs in patients with high BMI (even after adjusting for arthralgias, which are common in obese patients) suggests that the chronic inflammation associated with obesity may play a role in extraintestinal inflammation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".