The Korean Journal of Internal Medicine

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Original Article
Korean J Intern Med. 2025;40(4):606-615. Published online July 1, 2025.
DOI: https://doi.org/10.3904/kjim.2024.349
Impact of body mass index on clinical outcomes in intestinal Behçet’s disease
Daye Park1,2, Jihye Park1,2, Soo Jung Park1,2, Jae Jun Park1,2, Tae Il Kim1,2, Jae Hee Cheon1,2 
1Department of Internal Medicine, Severance Hospital, Yonsie University College of Medicine, Seoul, Korea
2Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Corresponding author: Jae Hee Cheon ,Tel: +82-2-2228-1990, Fax: +82-2-393-6884, Email: geniushee@yuhs.ac
Received: October 4, 2024; Revised: January 2, 2025   Accepted: February 20, 2025.
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.

Keywords :Behcet syndrome; Body mass index; Prognosis; Nutrition
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