Analysis Of The Effect Of Body Mass Index On The Disease Progression And Severity Of Patients With Ulcerative Colitis

Background:Inflammatory bowel disease(IBD)is a chronic non-specific intestinal inflammatory disease characterized by an abnormal immune response of the mucosal immune system to antigenic substances in the intestinal lumen,including ulcerative colitis(UC),Crohn’s disease(CD)and Uncertain colitis.The pathogenesis of IBD is still unclear,and existing research suggests that it may be due to dietary,genetic,environmental and autoimmune factors.At present,the research on UC has become a hot spot.The clinical manifestations of UC are diverse,mainly manifested as mucus pus and bloody stool,diarrhea,abdominal pain and sensation after urgency.UC affects the entire digestive tract through chronic inflammatory reactions,which may lead to weight loss and a decline in nutritional status,but studies have shown that the onset of ulcerative colitis is accompanied by overweight and obesity.This is contrary to the traditional concept.Obesity,which may be associated with a variety of autoimmune diseases,such as rheumatoid arthritis,psoriasis,etc.,while UC is also defined as an autoimmune disease,obesity on UC and others.The process and treatment of autoimmune diseases have a certain impact.Some studies have shown that fat cells produce some cytokine-mediated mediators that promote inflammatory responses.Chronic inflammatory responses are one of the mechanisms involved in obesity and ulcerative colitis.Other studies have shown that intestinal flora imbalance in obese patients also makes them There is a potential correlation.In recent years,ulcerative colitis and obesity are hot topics of research,but the current research on the correlation between the two is rarely reported in domestic and foreign literatures.According to the collection of 157 cases according to the 2017 Ecco European Evidence Consensus(ECCO,European Crons and Colitis organization)a clinical practice guideline for inflammatory bowel disease,classifies patients according to the current standard recommended by the World Health Organization,BMI(body mass index),and further summarizes each The clinical characteristics of UC patients with stage BMI values provide a basis for the correlation between obesity and ulcerative colitis,and provide new ideas for the prevention and treatment of ulcerative colitis.Objectives:The pathogenesis of ulcerative colitis is still unclear,and clinical diagnosis and treatment are quite difficult.At present,there are many related factors related to ulcerative colitis.This study is based on obesity and overweight patients with ulcerative colitis,and collects Henan University.Patients with ulcerative colitis diagnosed during the first affiliated hospital from 2017.01—2018.12 were classified according to their BMI values,analyzed and summarized,and the clinical features of ulcerative colitis at each BMI stage were summarized.It was found that overweight and obesity on ulcerative colon The clinical impact of patients with inflammation,objective evaluation of the clinical characteristics of patients with ulcerative colitis with different BMI values,provide a reference for clinicians.Methods:The 157 cases of ulcerative colitis diagnosed according to the 2017 Ecco European Evidence Consensus(ECCO,European Crons and Colitis organization),Clinical Practice Guidelines for Inflammatory Bowel Disease)were collected from the First Affiliated Hospital of Henan University during the period from 2017.01 to 2018.12.According to the body mass index(BMI)of the inpatients’ nutritional assessment,the patients were divided into four groups.The normal body weight was defined as BMI between 18.5-23.9,lower than 18.5 was defined as low body weight,and overweight was defined as 24 Between-27.9,a BMI greater than or equal to 28 is defined as obesity.Collect general clinical statistics,complications,severity of illness,laboratory indicators,clinical quality of life,medication status,and length of hospital stay,and perform statistical analysis on these data to further summarize the clinical outcomes of UC patients at each BMI stage.Characteristics,analysis of the effects of overweight and obesity on the severity of patients with ulcerative colitis.Results:1.Comparison of baseline data: A total of 157 patients with UC were enrolled,15(9.55%)were low weight,32(20.38%)were normal weight,54(34.39%)were overweight,and 56(35.67)%)is obese;the maximum age of the selected patients is 78 years old,the minimum age is 29 years old,and the overall average age is(49.87±9.38)years old;79 male patients,accounting for 50.3% of the total,78 female patients For example,it accounts for 49.7% of the total.There were no statistical differences in baseline data such as gender distribution,age distribution,smoking history,and drinking history among the 4 groups(P>0.05).2.Comparison of disease time and laboratory parameters: There was a statistically significant difference in disease time between the 4 groups(P<0.05).The disease time of the 4 groups of UC patients increased with the increase of body weight;CRP between the 4 groups of patients There was a significant difference in the ratio of ESR values to normal values(P<0.05).there were significant differences in CRP and ESR between the 4 groups of UC patients(P<0.05),and the patient’s CRP value and ESR value Increase in weight.3.Comparison of complications: There were differences in the proportion of hyperlipidemia,diabetes and hypertension among the 4 groups(P<0.05).Further comparison between the two groups showed that the proportion of hyperlipidemia and diabetes in the overweight and obese groups was higher than that of the low body weight.Recombination with normal body;the proportion of hyperlipidemia and diabetes mellitus in normal body reorganization was higher than that in low body recombination;the proportion of hypertension in 4 groups increased with the increase of body weight(P<0.05).4.Comparative analysis of the severity of the disease between different BMI values: There was a significant difference in the severity of the disease between the 4 groups(P<0.05),low body weight and normal body reorganization were all mild and moderate patients;overweight and obesity group Most of the patients were moderately and moderately.Spearman correlation analysis showed that there was a significant positive correlation between BMI and disease severity.5.Comparative analysis of drug use in patients with different BMI groups: There were differences in the application of glucocorticoids in UC patients between the 4 groups(P<0.05).Further comparison between the two groups revealed that the glucocorticoid application rate of UC patients in the overweight and obese group was higher than that of low body weight and normal body recombination.The glucocorticoid application rate of normal UC patients was higher than that of low body reorganization;4 groups of patients The proportion of immunosuppressive agents and the ratio of the two drugs in combination with the increase in body weight showed an increasing trend(P<0.05).6.Comparison of short quality of life scores(IBDQ)between groups of different BMI patients: There were differences in IBDQ scores among the 4 groups(P<0.05).Further comparison between the two groups showed that the IBDQ scores and total scores of the four dimensions of the patients in the four groups decreased with the increase of body weight(P<0.05).7.Comparison of IBDQ scores between different severity of illness: There were significant differences in the quality of life scores and the scores of each dimension between the patients with mild,moderate,and severe UC(P<0.001).Further two-two comparisons showed that the IBDQ scores and total scores of the three groups showed a decreasing trend with the severity of the disease.8.Multiple linear regression analysis of quality of life in patients with UC: Obesity was an independent factor in the quality of life of patients with UC(P<0.05),and other factors remained unchanged,with non-obese.Compared with the UC population,the quality of life score of the obese UC population showed a downward trend.Conclusions:1.The results of this study indicate that with the increase in BMI,the disease time of patients with UC is also prolonged;UC patients with overweight and obesity have a higher incidence of clinical complications such as hyperlipidemia,hypertension and diabetes.More attention should be paid to and close follow-up of overweight and obese UC patients,paying attention to the occurrence of clinical comorbidities;patients’ BMI values are significantly positively correlated with the severity of the disease,and overweight and obesity may affect the severity of UC patients.2.Overweight and obese UC patients have higher CRP and ESR levels,and may need glucocorticoids and immunosuppressive agents to maintain treatment;obesity is an independent factor in the quality of life of patients with UC,obese UC patients have A lower quality of life score.