Obesity and sarcoidosis: consequence or contributor?

Curr Opin Pulm Med. 2018 Sep;24(5):487-494. doi: 10.1097/MCP.0000000000000503.

Abstract

Purpose of review: Sarcoidosis is a multisystem disease of unknown cause. Obesity can affect many physiological factors. The relationship between obesity and sarcoidosis is unclear, and can been described as posing a 'chicken and egg' scenario for the patient as it is not always clear whether it is a consequence of, or a risk factor for any disease. The purpose of this review is to examine the dual roles of obesity on sarcoidosis morbidity and the incidence.

Recent findings: Obesity magnifies the symptoms of sarcoidosis and corticosteroid therapy increases BMI. Prospective epidemiologic studies started to explore the role of obesity as a potential risk factor for sarcoidosis. Three studies in the United States, and one study in Denmark, have demonstrated significantly increased risks of sarcoidosis among obese compared with nonobese patients; risk estimates ranged from 1.42 [95% confidence interval (CI), 1.07-1.89] to 3.59 (95% CI, 2.31-5.57).

Summary: Obesity can be both a consequence of sarcoidosis treatment, and a contributor to disease risk likely through the pro-inflammatory environment of obesity. Prospective epidemiologic cohort studies are needed to explore the cause of sarcoidosis and insight into possible avenues of treatment development and prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Body Mass Index
  • Humans
  • Incidence
  • Obesity / chemically induced
  • Obesity / epidemiology*
  • Obesity / physiopathology
  • Prospective Studies
  • Risk Factors
  • Sarcoidosis / drug therapy*
  • Sarcoidosis / epidemiology*
  • Sarcoidosis / physiopathology

Substances

  • Adrenal Cortex Hormones