The Association between Central Obesity and the Risk of Irritable Bowel Syndrome: A Case-control Study

Bilal Natiq Nuaman^1,

¹Department of Medicine, College of Medicine, Al-Iraqia University Baghdad, Iraq

Cite this paper:
Bilal Natiq Nuaman. The Association between Central Obesity and the Risk of Irritable Bowel Syndrome: A Case-control Study. American Journal of Medical Sciences and Medicine. 2017; 5(2):23-26. doi: 10.12691/ajmsm-5-2-1

Abstract

Background: Central obesity and Irritable Bowel Syndrome (IBS) are common medical conditions with similar etiologic mechanisms. There are limited studies to evaluate the association between obesity, especially central obesity; with IBS. Establishing such association is important in the management of IBS. Objective: To evaluate the association between central obesity and IBS in Iraqi patients using Waist-to-Height ratio (WtHR) as an index of central obesity. Patients and Methods: Central obesity defined by Waist-to-Height ratio > 0.5. Inclusion and exclusion criteria for diagnosing IBS were used. A case-control study was performed at AL-Nuaman Teaching Hospital in the period from January 2015 to December 2015, Comparing Waist-to-Height ratio (WtHR) between 75 patients (with IBS) and 130 controls (without IBS) to assess the association between central obesity and IBS. Chi-square test with 95% confidence was used to evaluate association between central obesity and IBS, and Odds ratio (OR) for central obesity was determined. Results: There is significant association between central obesity and IBS, x² (1) = 36.2, P < 0.001). The strength of association using phi coefficient is medium positive (φ=42, p<0.001). Conclusion: Central obesity is significantly associated with IBS and may be regarded as a risk factor for IBS.

Keywords:
central obesity IBS Waist-to-Height ratio (WtHR) case-control study

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis. Clin Gastroenterol Hepatol 2012; 10:712 21.
[2]	Niec A, Frankum B, Talley N. Are adverse food reactions linked to irritable bowel syndrome? Am J Gastroenterol 1998; 93: 2184-90.
[3]	Madden J, Hunter J. A review of the role of the gut microflora in irritable bowel syndrome and the effects of probiotics. Br J Nutr 2002; 88:S67-72.
[4]	Ford AC, Talley NJ. Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: A systematic review. J Gastroenterol 2011; 46: 421-31.
[5]	Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006; 101 (11): 2619-2628.
[6]	Hampel H, Abraham N, El-Serag H. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005; 143: 199.
[7]	Locke GR, Talley NJ, Fett SL, et al. Risk factors associated with symptoms of gastroesophageal reflux. AmJ Med.1999; 106: 642-649.
[8]	Gortmaker S, Must A, Perrin J, et al. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993; 329: 1008-12.
[9]	Ruderman N, Chisholm D, Pi-Sunyer X, et al. The metabolically obese, normal-weight individual revisited. Diabetes. 1998; 47: 699-713.
[10]	Parikh RM, Joshi SR, Menon PS, Shah NS. Index of central obesity- A novel parameter. Medical Hypotheses. 2007; 68: 1272-1275.
[11]	Ashwell M, Cole T, Dixon A. Ratio of waist circumference to height is strong predictor of intra-abdominal fat. BMJ. 1996; 313: 559-560.
[12]	Drossman D, Corrazziari E, Delvaux M, et al. Rome III: the functional Gastrointestinal Disorders. 3rd ed. McLean, VA: Degnon Associates; 2006.
[13]	Tibble J, Sigthorsson G, Foster R, et al. Use of surrogate markers of inflammation and Rome criteria to distinguish organic from nonorganic intestinal disease.Gastroenterology 2002; 123: 450-60.
[14]	Sadik R, Björnsson E, Simrén M. The relationship between symptoms, body mass index, gastrointestinal transit and stool frequency in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2010; 22(1): 102-108. 416 Gastroenterology & Hepatology Volume 10, Issue 7 July 2014.
[15]	Clements RH, Gonzalez QH, Foster A, et al. Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with laparoscopic Rouxen-Y gastric bypass. Obes Surg. 2003; 13(4): 610 614.
[16]	Roberson EN, Gould JC, Wald A. Urinary and fecal incontinence after bariatric surgery. Dig Dis Sci.2010; 55(9): 2606-2613.
[17]	Fysekidis M, Bouchoucha M, Bihan H, Reach G, Benamouzig R, Catheline JM. Prevalence and co-occurrence of upper and lower functional gastrointestinal symptoms in patients eligible for bariatric surgery. Obes Surg.2012; 22(3): 403-410.
[18]	Simrén M, Månsson A, Langkilde AM, Svedlund J, Abrahamsson H, Bengtsson U, Björnsson ES. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001; 63(2): 108-15.
[19]	Lee SH, Kim KN, Kim KM, and Joo NS. Irritable Bowel Syndrome May Be Associated with Elevated Alanine Aminotransferase and Metabolic Syndrome. Yonsei Med J. 2016 Jan 1; 57(1): 146-152.
[20]	Lee CG, Lee JK, Kang YS, Shin S, Kim JH, Lim YJ, et al. Visceral abdominal obesity is associated with an increased risk of irritable bowel syndrome. Am J Gastroenterol. 2015 Feb; 110(2): 310-9.
[21]	Talley NJ, Howell S, Poulton R. Obesity and chronic gastrointestinal tract symptoms in young adults: a birth cohort study. Am J Gastroenterol. 2004; 99: 1807-14.
[22]	Kubo M, Fujiwara Y, Shiba M, Kohata Y, Yamagami H, Tanigawa T, et al. Differences between risk factors among irritable bowel syndrome subtypes in Japanese adults. Neurogastroenterol Motil. 2011 Mar; 23(3):249-54.
[23]	Kang HW, Lee CG, Kim JH, Lim YJ, Lee JK, Koh MS, et al. Visceral abdominal obesity as a risk factor for irritable bowel syndrome: a case-control study. Gastroenterology. 2014; 146 (5 Suppl 1): S-178.
[24]	Hosoda H, Kojima M, Kangawa K, Ghrelin and the regulation of food intake and energy balance. Mol Interv. 2002 Dec; 2(8): 494-503.
[25]	Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006; 444 (7122): 1022-1023.
[26]	Kassinen A, Krogius-Kurikka L, Mäkivuokko H, et al. The fecal microbiota of irritable bowel syndrome patients differs significantly from that of healthy subjects. Gastroenterology. 2007; 133(1): 24-33.
[27]	Turnbaugh PJ, Bäckhed F, Fulton L, Gordon JI. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe. 2008; 3(4): 213-223.
[28]	Jeffery IB, Quigley EM, Öhman L, Simrén M, O’Toole PW. The microbiota link to irritable bowel syndrome: an emerging story. Gut Microbes. 2012; 3(6):572-576.
[29]	Simrén M, Barbara G, Flint HJ, et al; Rome Foundation Committee. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013; 62(1): 159-176.
[30]	Mayer E, Collins S. Evolving pathophysiologic models functional gastrointestinal disorders. Gastroenterology2002; 122: 2032-48.
[31]	Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med 2012; 367: 1626-35.
[32]	ScullyP, Mckernan DP, KeohaneJ, et al. Plasma cytokine profiles in females with irritable bowel syndrome and extra-intestinal comorbidity. Am J Gastroenterol 2010; 105: 2235.
[33]	Hirsch J, Knittle JL. Cellularity of obese and non-obese human adipose tissue. Fed Proc. 1970; 29: 1516-1521.
[34]	Peraldi P, Spiegelman B. TNF- α and insulin resistance: summary and future prospects. Mol Cell Biochem. 1998; 182: 169-171.
[35]	Mohamed-Ali V, Pinkney JH, Coppack SW. Adipose tissue as an endocrine and paracrine organ. Int J Obes Relat Metab Disord. 1998; 22: 1145-1158.
[36]	Bastard JP, Jardel C, Bruckert E, et al. Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab. 2000; 85: 3338-3342.