A new study from researchers at Cedars-Sinai has found that the mass and composition of our bodies can significantly influence the effectiveness of medications.
Specifically, patients with inflammatory bowel disease (IBD) who have higher levels of intra-abdominal visceral adipose tissue (a type of fat found in the abdomen) are less likely to enter remission when treated with certain anti-inflammatory medications.
The study has been published in the journal Gastroenterology.
Specific Findings
Patients in the study with higher levels of visceral fat had lower concentrations of the biologic medications in their blood after treatment, leading to lower rates of steroid-free remission and bowel healing.
“Even though biologic medications have significantly improved outcomes for our patients with Crohn’s disease or ulcerative colitis, some people do not respond well to these therapies,” said Andres J. Yarur, MD, the gastroenterologist who served as the corresponding author of the study.
“In our study, we found that the patients with higher amounts of internal abdominal fat were less likely to improve and experience remission from their disease.”
Implications for Treatment
The findings suggest that treatment plans for IBD might need to be adjusted based on the patient’s body composition, particularly their amount of intra-abdominal visceral fat.
“It may not be body weight or body mass index [BMI] that is the reason some of our patients benefit from these approved biologic medications.
It seems the fat tissue on the inner side of the abdomen, in particular, impacts treatment, so we may need to use higher doses of the drugs to help these patients,” said Gil Melmed, MD, a co-author of the study and director of Inflammatory Bowel Disease Clinical Research at Cedars-Sinai.
Further research is needed to fully understand the relationship between visceral fat and the efficacy of IBD treatments.
It’s also unclear whether interventions that improve the body composition of IBD patients or adjusting the doses of the medications could enhance the effectiveness of the drugs.
As Yarur, the study’s principal investigator, noted, “We need to investigate drugs with different mechanisms of action, especially other small molecules, to see if our findings hold.
As the prevalence of obesity and metabolic syndrome increases in our population, we need to find interventions that would improve the body composition of these IBD patients who are not currently helped by these biologic treatments.”
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The study was published in Gastroenterology.
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