Impact of body mass index on clinical outcomes in intestinal Behçet’s disease

Abstract

Background/Aims: The impact of body mass index (BMI) on the clinical outcomes of intestinal Behçet’s disease (BD) remains unclear. This study assessed the association between BMI and disease progression. Methods: A retrospective analysis of 760 patients with intestinal BD was conducted. Patients were classified by BMI as underweight (< 18.5 kg/m2), normal (18.5–22.9), overweight (23.0–24.9), or obese (≥ 25.0). The association between BMI and clinical outcomes—biologics, surgery, hospitalization, and emergency visits—was examined. Results: Among 760 patients, 130 (17.1%) were underweight, 384 (50.5%) normal, 152 (20.0%) overweight, and 94 (12.4%) obese. Higher BMI linked to lower cumulative rates of biologics use (p trend = 0.002), surgery (p trend = 0.004), hospitalization (p trend = 0.004), and emergency visits (p trend = 0.008). Compared with the underweight group, the normal (HR 0.667, 95% CI 0.483–0.922, p = 0.014), overweight (HR 0.589, 95% CI 0.394–0.879, p = 0.010), and obese groups (HR 0.515, 95% CI 0.321–0.828, p = 0.006) had lower hospitalization risks. The overweight (HR 0.490, 95% CI 0.241–0.996, p = 0.049) and obese (HR 0.312, 95% CI 0.116–0.840, p = 0.021) groups were negatively associated with future biologics use. The normal (HR 0.705, 95% CI 0.480–1.036, p = 0.075) and obese (HR 0.510, 95% CI 0.272–0.953, p = 0.035) groups were negatively associated with future surgery in multivariable analysis. Conclusions: Lower BMI was linked to poorer clinical outcomes in intestinal BD, emphasizing the need to optimize nutritional status.