Significant Differences Between Crohn's Disease and Ulcerative Colitis Regarding the Impact of Body Mass Index and Initial Disease Activity on Responsiveness to Azathioprine: Results from a European Multicenter Study in 1,176 Patients

被引：33

作者：

Holtmann, Martin H. ^{[1
]}

Krummenauer, Frank ^{[2
]}

Claas, Christina ^{[1
]}

Kremeyer, Kristina ^{[1
]}

Lorenz, Dirk ^{[1
]}

Rainer, Olivia ^{[1
]}

Vogel, Iris ^{[1
]}

Boecker, Ulrich ^{[3
]}

Boehm, Stephan ^{[4
]}

Buening, Carsten ^{[5
]}

Duchmann, Rainer ^{[6
]}

Gerken, Guido ^{[7
]}

Herfarth, Hans ^{[8
]}

Luegering, Norbert ^{[9
]}

Kruis, Wolfgang ^{[10
]}

Reinshagen, Max ^{[11
]}

Schmidt, Jan ^{[12
]}

Stallmach, Andreas ^{[13
]}

Stein, Juergen ^{[14
]}

Sturm, Andreas ^{[15
]}

Galle, Peter R. ^{[1
]}

Hommes, Daan W. ^{[16
]}

D'Haens, Geert ^{[17
]}

Rutgeerts, Paul ^{[17
]}

Neurath, Markus F. ^{[1
]}

机构：

[1] Johannes Gutenberg Univ Mainz, Dept Med 1, D-55131 Mainz, Germany

[2] Johannes Gutenberg Univ Mainz, Dept Med Biometr Epidemiol & Informat, D-55131 Mainz, Germany

[3] Univ Hosp, Dept Med 2, Mannheim, Germany

[4] Univ Marburg, Univ Hosp, Dept Gastroenterol, Marburg, Germany

[5] Charite, Dept Gastroenterol, Berlin, Germany

[6] Univ Med Berlin Charite, Med Clin 1, Berlin, Germany

[7] Univ Hosp, Dept Gastroenterol, Essen, Germany

[8] Univ Hosp, Dept Gastroenterol, Regensburg, Germany

[9] Univ Hosp, Dept Gastroenterol, Munster, Germany

[10] Kalk Hosp, Dept Internal Med, Cologne, Germany

[11] Univ Hosp, Dept Gastroenterol, Ulm, Germany

[12] Univ Heidelberg Hosp, Dept Surg, Heidelberg, Germany

[13] Univ Hosp, Dept Gastroenterol, Jena, Germany

[14] Goethe Univ Frankfurt, Dept Gastroenterol, Frankfurt, Germany

[15] Univ Berlin, Virchow Hosp, Dept Gastroenterol, Berlin, Germany

[16] Univ Amsterdam, Acad Med Ctr, Dept Gastroenterol, NL-1105 AZ Amsterdam, Netherlands

[17] Univ Hosp, Dept Gastroenterol, Leuven, Belgium

来源：

DIGESTIVE DISEASES AND SCIENCES | 2010年 / 55卷 / 04期

关键词：

Azathioprine; Crohn's disease; Ulcerative colitis; Disease activity; Body mass index; RECURRENCE;

D O I：

10.1007/s10620-009-0846-9

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

In a survey comprising 1,176 patients with inflammatory bowel disease (IBD) we recently showed that azathioprine (AZA) beyond 4 years is beneficial in ulcerative colitis (UC) patients and in a subset of Crohn's disease (CD) patients. Here, we show for the first time that azathioprine responsiveness depends on body mass index (BMI). The relationship is reciprocal in UC and CD, with a better outcome in UC patients with a BMI<25 and in CD patients with a BMI>25. These observations are particularly interesting considering the evolving concept of a relationship between fatty metabolism and immune regulation. Additionally, we show that CD patients, but not UC patients, respond better to AZA when it is started in clinical remission. This observation may support data favouring a "hit hard and early'' regime in CD. Finally, we were able to demonstrate a decrease in the incidence of CD-related complications requiring surgery through treatment with AZA.

引用

页码：1066 / 1078

页数：13

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