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Does Obesity Influence the Risk of Clostridium difficile Infection Among Patients with Ulcerative Colitis?

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Abstract

Background

Patients with ulcerative colitis (UC) are at an increased risk of Clostridium difficile infection (CDI) compared with the general population. Recent data suggest that obesity also increases the risk of CDI.

Aims

To examine whether obesity influences the risk of CDI among patients with UC.

Study

We conducted a retrospective cross-sectional study of UC patients seen in gastroenterology clinic between January 1, 2014, and December 31, 2015. Records were reviewed for patients with the diagnosis of UC prior to 2014, and the first diagnosis of CDI between January 1, 2014, and December 31, 2015. Using body mass index (BMI), patients were classified into underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). Age-adjusted and multivariate logistic regression was performed including gender, tobacco use, UC disease duration, medication exposure, and vitamin D deficiency.

Results

Of the 636 patients with UC, 114 (18%) were obese, 232 (36%) overweight, 274 (43%) normal weight, and 16 (2.5%) underweight. Nineteen patients (3.0%) developed CDI during the study period. CDI risk was not associated with BMI (OR 0.90, 95% CI 0.79–1.02). Compared to normal weight patients, risk of CDI was not influenced by being obese (multivariate OR 0.63, 95% CI 0.15–2.58), overweight (multivariate OR 0.33, 95% CI 0.08–1.30), or underweight (multivariate OR 2.98, 95% CI 0.45–19.83). CDI was associated with ever use of TNF therapy (multivariate OR 6.09, 95% CI 2.07–17.93) but not vedolizumab (multivariate OR 0.76, 95% CI 0.08–7.36).

Conclusions

Obesity does not appear to be associated with the risk of C. difficile infection among patients with UC.

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Acknowledgments

Research reported in this publication was supported by the Scripps Clinic Medical Group Research & Education Award (G.G.K.).

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Authors and Affiliations

  1. Division of Gastroenterology, Scripps Clinic, 10666 N. Torrey Pines Rd, La Jolla, CA, 92037, USA

    Sajiv Chandradas, Warren Reidel & Gauree G. Konijeti

  2. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA

    Hamed Khalili & Ashwin Ananthakrishnan

  3. University of Southern California, Los Angeles, CA, USA

    Connor Wayman

  4. Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA

    Jill Waalen

Authors
  1. Sajiv Chandradas
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  2. Hamed Khalili
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  3. Ashwin Ananthakrishnan
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  4. Connor Wayman
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  5. Warren Reidel
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  6. Jill Waalen
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  7. Gauree G. Konijeti
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Contributions

GGK contributed to study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript, and funding. SC contributed to study concept and design, acquisition of data, analysis and interpretation of data, and drafting of the manuscript. CW contributed to acquisition of data, analysis and interpretation of data, and critical revision of the manuscript. HK, AA, JW, and WR contributed to analysis and interpretation of data and critical revision of the manuscript.

Corresponding author

Correspondence to Gauree G. Konijeti.

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Conflict of interest

Gauree Gupta Konijeti: Previously received honoraria from Abbvie, Janssen, Pfizer, and Takeda. The other authors report no relevant conflict of interest.

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Chandradas, S., Khalili, H., Ananthakrishnan, A. et al. Does Obesity Influence the Risk of Clostridium difficile Infection Among Patients with Ulcerative Colitis?. Dig Dis Sci 63, 2445–2450 (2018). https://doi.org/10.1007/s10620-018-5108-2

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  • DOI: https://doi.org/10.1007/s10620-018-5108-2

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