Sandler RS, Keku TO, Woosley JT, Sandler DP, Galanko JA, Peery AF. Obesity is associated with decreased risk of microscopic colitis in women. World J Gastroenterol 2022; 28(2): 230-241 [PMID: 35110947 DOI: 10.3748/wjg.v28.i2.230]
Corresponding Author of This Article
Robert S Sandler, MD, MPH, Professor, Department of Medicine, University of North Carolina, No. 130 Mason Farm Road, Chapel Hill, NC 27599-7555, United States. rsandler@med.unc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 14, 2022; 28(2): 230-241 Published online Jan 14, 2022. doi: 10.3748/wjg.v28.i2.230
Obesity is associated with decreased risk of microscopic colitis in women
Robert S Sandler, Temitope O Keku, John T Woosley, Dale P Sandler, Joseph A Galanko, Anne F Peery
Robert S Sandler, Temitope O Keku, Joseph A Galanko, Anne F Peery, Department of Medicine, University of North Carolina, Chapel Hill, NC 27514-7555, United States
John T Woosley, Department of Pathology, University of North Carolina, Chapel Hill, NC 27514, United States
Dale P Sandler, Department of Health and Human Services, National Institute of Environmental Health Sciences, Durham, NC 27709, United States
Author contributions: Sandler RS and Keku TO designed the research and obtained funding; Sandler RS, Keku TO and Woosley JT acquired the data; Sandler RS, Keku TO, Woosley JT, Galanko JA, Sandler DP and Peery AF analyzed and interpreted the data and wrote the paper.
Supported bythe National Institutes of Health, No. P30 DK034987 and No. R01 DK105114.
Institutional review board statement: The study was approved by the University of North Carolina Office of Human Research Ethics. All patients gave informed consent.
Conflict-of-interest statement: Disclosures: None of the authors have financial, professional or personal conflicts of interest.
Data sharing statement: Data will not be available to other researchers.
STROBE statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Robert S Sandler, MD, MPH, Professor, Department of Medicine, University of North Carolina, No. 130 Mason Farm Road, Chapel Hill, NC 27599-7555, United States. rsandler@med.unc.edu
Received: September 12, 2021 Peer-review started: September 12, 2021 First decision: October 16, 2021 Revised: October 18, 2021 Accepted: December 31, 2021 Article in press: December 31, 2021 Published online: January 14, 2022 Processing time: 120 Days and 13.6 Hours
ARTICLE HIGHLIGHTS
Research background
There is limited information about risk factors for microscopic colitis, a leading cause of chronic watery diarrhea.
Research motivation
We hypothesized that obesity might be associated with microscopic colitis.
Research objectives
To compare patients with microscopic colitis to patients with chronic diarrhea to learn more about associations with obesity and hormones.
Research methods
We conducted a case-control study among patients who were referred to a single academic medical center for chronic diarrhea. The biopsies were reviewed by a research pathologist and classified as microscopic colitis cases or diarrhea controls. We used logistic regression to estimate odds ratios and 95% confidence intervals.
Research results
Cases with microscopic colitis had a lower body mass index than controls in adjusted models. Although patients with microscopic colitis reported that they lost more weight following the onset of diarrhea, the associations with BMI persisted in analyses stratified by weight loss. Oral contraceptives were inversely associated with microscopic colitis.
Research conclusions
Microscopic colitis cases were less likely to be obese than diarrhea controls. While the mechanism behind the association is not known, it could involve hormonal effects of obesity or the gut microbiome.
Research perspectives
Additional research is needed to understand the association between obesity and microscopic colitis.
