{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T20:22:44Z","timestamp":1784665364097,"version":"3.55.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Center for Population Medicine"},{"DOI":"10.13039\/100007605","name":"Aarhus University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007605","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Aarhus University Hospital, Denmark"},{"DOI":"10.13039\/501100004836","name":"Danish Council for Independent Research","doi-asserted-by":"publisher","award":["8020-00322B"],"award-info":[{"award-number":["8020-00322B"]}],"id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"publisher","award":["NNF18OC0052917"],"award-info":[{"award-number":["NNF18OC0052917"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010983","name":"Health Research Fund of Central Denmark Region","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010983","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Obesity is associated with various gastrointestinal (GI) conditions. Because of the epidemic rise of obesity, we examined associations between overweight\/obesity and incidence of individual GI diseases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Denmark, 1997-2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Using nationwide healthcare registries, we identified All Danes \u226518 years with a hospital diagnosis of overweight\/obesity. We created an age- and sex-matched general population comparison cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Exposure<\/jats:title>\n                  <jats:p>A diagnosis code of overweight\/obesity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcomes and Measures<\/jats:title>\n                  <jats:p>We compared the incidence of hospital-diagnosed GI diseases from 1 year after overweight\/obesity diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 129 466 patients with overweight\/obesity (70.9% female, median age 49.3 years). Their incidence rate of GI disease was 30.1 per 1000 person years (95% CI: 29.8-30.5) vs 16.7 (95% CI: 16.5-16.8) for comparators, yielding an adjusted hazard ratio (aHR) of 1.7 (95% CI: 1.7-1.7). The aHRs indicated elevated risk of all GI disease sub-types in the overweight\/obesity cohort, including cholelithiasis: 2.8 (95% CI: 2.7-2.9), cholecystitis: 2.6 (95% CI: 2.4-2.8), acute pancreatitis: 2.2 (95% CI: 2.0-2.4), stomach ulcer: 2.0 (95% CI: 1.9-2.1), cirrhosis: 1.5 (95% CI: 1.3-1.7), and obesity-associated GI cancer: 1.2 (95% CI: 1.2-1.3). The aHR for any GI disease was 1.4 (95% CI: 1.4-1.5) in men and 1.9 (95% CI: 1.8-1.9) in women. Among patients 18 to &amp;lt;30 years, the aHR was 2.6 (95% CI: 2.5-2.7) vs 1.3 (95% CI: 1.3-1.4) among individuals \u226570 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions and Relevance<\/jats:title>\n                  <jats:p>Overweight\/obesity is a risk factor for a wide range of GI diseases and is expected to become an even greater clinical challenge in the future.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf077","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T19:40:45Z","timestamp":1744314045000},"page":"540-548","source":"Crossref","is-referenced-by-count":3,"title":["Overweight\/obesity and gastrointestinal disease incidence in Denmark\u2014a cohort study"],"prefix":"10.1093","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8681-6822","authenticated-orcid":false,"given":"Sigrid Bjerge","family":"Gribsholt","sequence":"first","affiliation":[{"name":"Department of Clinical Epidemiology, Center for Population Medicine, Aarhus University and Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]},{"name":"Department of Endocrinology and Internal Medicine, Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]},{"name":"Steno Diabetes Center Aarhus, Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00f3ra K\u00f6rmendin\u00e9","family":"Farkas","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Center for Population Medicine, Aarhus University and Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6641-1430","authenticated-orcid":false,"given":"Peter","family":"Jepsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Center for Population Medicine, Aarhus University and Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]},{"name":"Department of Hepatology and Gastroenterology, Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f8rn","family":"Richelsen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Aarhus, Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]},{"name":"Institute of Clinical Medicine, Aarhus University , 8200 Aarhus N ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Center for Population Medicine, Aarhus University and Aarhus University Hospital , 8200 Aarhus N ,","place":["Denmark"]},{"name":"Institute of Clinical Medicine, Aarhus University , 8200 Aarhus N ,","place":["Denmark"]},{"name":"Clinical Excellence Research Center, Stanford University , Palo Alto, CA 94305-5101 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"2025050706570866000_lvaf077-B1","author":"World Health Organization"},{"key":"2025050706570866000_lvaf077-B2","doi-asserted-by":"publisher","first-page":"1061453","DOI":"10.3389\/fpubh.2023.1061453","article-title":"Global, regional, and national burden of 10 digestive diseases in 204 countries and territories from 1990 to 2019","volume":"11","author":"Wang","year":"2023","journal-title":"Front Public Health"},{"issue":"2","key":"2025050706570866000_lvaf077-B3","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1080\/00365521.2021.1994643","article-title":"Abdominal obesity increases the risk of reflux esophagitis: a systematic review and meta-analysis","volume":"57","author":"Zhan","year":"2022","journal-title":"Scand J Gastroenterol"},{"issue":"6","key":"2025050706570866000_lvaf077-B4","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.3390\/nu11061288","article-title":"Obesity and risk of peptic ulcer disease: a large-scale health check-up cohort study","volume":"11","author":"Pyo","year":"2019","journal-title":"Nutrients"},{"issue":"4","key":"2025050706570866000_lvaf077-B5","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1159\/000516047","article-title":"Excess body weight and abdominal hernia","volume":"37","author":"Dietz","year":"2021","journal-title":"Visc Med"},{"issue":"1","key":"2025050706570866000_lvaf077-B6","doi-asserted-by":"publisher","first-page":"66","DOI":"10.15403\/jgld-3208","article-title":"Environmental and dietary risk factors for colonic diverticulosis and diverticulitis","volume":"30","author":"Lukosiene","year":"2021","journal-title":"J Gastrointestin Liver Dis"},{"issue":"1","key":"2025050706570866000_lvaf077-B7","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s40608-017-0159-z","article-title":"Prevalence and predictors of irritable bowel syndrome in patients with morbid obesity: a cross-sectional study","volume":"4","author":"Aasbrenn","year":"2017","journal-title":"BMC Obes."},{"issue":"1","key":"2025050706570866000_lvaf077-B8","doi-asserted-by":"publisher","first-page":"e0190600","DOI":"10.1371\/journal.pone.0190600","article-title":"Relation of body mass index to risk of developing inflammatory bowel disease amongst women in the Danish national birth cohort","volume":"13","author":"Mendall","year":"2018","journal-title":"PLoS One"},{"issue":"4","key":"2025050706570866000_lvaf077-B9","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/S2213-8587(18)30154-2","article-title":"Non-alcoholic fatty liver disease: causes, diagnosis, cardiometabolic consequences, and treatment strategies","volume":"7","author":"Stefan","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"4","key":"2025050706570866000_lvaf077-B10","doi-asserted-by":"publisher","first-page":"e12983","DOI":"10.1111\/obr.12983","article-title":"Pathophysiological connections between gallstone disease, insulin resistance, and obesity","volume":"21","author":"Cort\u00e9s","year":"2020","journal-title":"Obes Rev"},{"issue":"5","key":"2025050706570866000_lvaf077-B11","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1097\/MOG.0000000000000386","article-title":"Obesity and pancreatitis","volume":"33","author":"Khatua","year":"2017","journal-title":"Curr Opin Gastroenterol."},{"issue":"10","key":"2025050706570866000_lvaf077-B12","doi-asserted-by":"publisher","first-page":"2740","DOI":"10.1007\/s10620-019-05603-9","article-title":"Obesity and the risk of gastrointestinal cancers","volume":"64","author":"Karczewski","year":"2019","journal-title":"Dig Dis Sci"},{"key":"2025050706570866000_lvaf077-B13","doi-asserted-by":"publisher","first-page":"563","DOI":"10.2147\/CLEP.S179083","article-title":"The Danish health care system and epidemiological research: from health care contacts to database records","volume":"11","author":"Schmidt","year":"2019","journal-title":"Clin Epidemiol"},{"issue":"8","key":"2025050706570866000_lvaf077-B14","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1007\/s10654-014-9930-3","article-title":"The Danish Civil Registration System as a tool in epidemiology","volume":"29","author":"Schmidt","year":"2014","journal-title":"Eur J Epidemiol"},{"key":"2025050706570866000_lvaf077-B15","doi-asserted-by":"publisher","first-page":"449","DOI":"10.2147\/CLEP.S91125","article-title":"The Danish National Patient Registry: a review of content, data quality, and research potential","volume":"7","author":"Schmidt","year":"2015","journal-title":"Clin Epidemiol"},{"key":"2025050706570866000_lvaf077-B16","doi-asserted-by":"publisher","first-page":"845","DOI":"10.2147\/CLEP.S214909","article-title":"Validity of ICD-10 diagnoses of overweight and obesity in Danish hospitals","volume":"11","author":"Gribsholt","year":"2019","journal-title":"Clin Epidemiol."},{"key":"2025050706570866000_lvaf077-B17","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.2147\/CLEP.S164456","article-title":"Sampling strategies for selecting general population comparison cohorts","volume":"10","author":"Heide-J\u00f8rgensen","year":"2018","journal-title":"Clin Epidemiol"},{"issue":"8","key":"2025050706570866000_lvaf077-B18","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1056\/NEJMsr1606602","article-title":"Body fatness and cancer\u2013viewpoint of the IARC working group","volume":"375","author":"Lauby-Secretan","year":"2016","journal-title":"N Engl J Med."},{"key":"2025050706570866000_lvaf077-B19","doi-asserted-by":"publisher","first-page":"261","DOI":"10.2147\/CLEP.S132628","article-title":"Positive predictive value of peptic ulcer diagnosis codes in the Danish National Patient Registry","volume":"9","author":"Viborg","year":"2017","journal-title":"Clin Epidemiol"},{"issue":"1","key":"2025050706570866000_lvaf077-B20","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1177\/1403494818773535","article-title":"Positive predictive value of acute and chronic pancreatitis diagnoses in the Danish National Patient Registry: a validation study","volume":"48","author":"Kirkeg\u00e5rd","year":"2020","journal-title":"Scand J Public Health"},{"issue":"2","key":"2025050706570866000_lvaf077-B21","doi-asserted-by":"publisher","first-page":"154","DOI":"10.3109\/00365529609031980","article-title":"Assessment of the diagnoses of Crohn's disease and ulcerative colitis in a Danish hospital information system","volume":"31","author":"Fonager","year":"1996","journal-title":"Scand J Gastroenterol"},{"issue":"1","key":"2025050706570866000_lvaf077-B22","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1023\/A:1022835207287","article-title":"Data quality of administratively collected hospital discharge data for liver cirrhosis epidemiology","volume":"21","author":"Vestberg","year":"1997","journal-title":"J Med Syst"},{"issue":"4","key":"2025050706570866000_lvaf077-B23","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1016\/j.mayocp.2020.10.004","article-title":"Sex- and gender-related differences in common functional gastroenterologic disorders","volume":"96","author":"Narayanan","year":"2021","journal-title":"Mayo Clin Proc"},{"key":"2025050706570866000_lvaf077-B24","doi-asserted-by":"publisher","first-page":"6757524","DOI":"10.1155\/2019\/6757524","article-title":"Gastrointestinal tract disorders in older age","volume":"2019","author":"Dumic","year":"2019","journal-title":"Can J Gastroenterol Hepatol"},{"issue":"1","key":"2025050706570866000_lvaf077-B25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/1471-2288-11-83","article-title":"The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients","volume":"11","author":"Thygesen","year":"2011","journal-title":"BMC Med Res Methodol."},{"issue":"7_suppl","key":"2025050706570866000_lvaf077-B26","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1177\/1403494811408483","article-title":"Danish registers on personal labour market affiliation","volume":"39","author":"Petersson","year":"2011","journal-title":"Scand J Public Health"},{"key":"2025050706570866000_lvaf077-B27","doi-asserted-by":"publisher","first-page":"100172","DOI":"10.1016\/j.lanepe.2021.100172","article-title":"Socioeconomic inequalities in the incidence of alcohol-related liver disease: a nationwide Danish study","volume":"8","author":"Askgaard","year":"2021","journal-title":"Lancet Reg Health Eur"},{"issue":"3","key":"2025050706570866000_lvaf077-B28","doi-asserted-by":"publisher","first-page":"47","DOI":"10.2307\/3002000","article-title":"Limitations of the application of fourfold table analysis to hospital data","volume":"2","author":"Berkson","year":"1946","journal-title":"Biometrics"},{"issue":"5","key":"2025050706570866000_lvaf077-B29","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1097\/01.ede.0000135174.63482.43","article-title":"A structural approach to selection bias","volume":"15","author":"Hern\u00e1n","year":"2004","journal-title":"Epidemiology"},{"issue":"2","key":"2025050706570866000_lvaf077-B30","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1191\/0962280202SM276ra","article-title":"Multi-state models for event history analysis","volume":"11","author":"Andersen","year":"2002","journal-title":"Stat Methods Med Res"},{"issue":"1","key":"2025050706570866000_lvaf077-B31","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1136\/gut.49.1.66","article-title":"Low socioeconomic class is a risk factor for upper and lower gastrointestinal symptoms: a population based study in 15 000 Australian adults","volume":"49","author":"Bytzer","year":"2001","journal-title":"Gut"},{"key":"2025050706570866000_lvaf077-B32","author":"The Danish Health and Medicines Authorities"},{"issue":"1","key":"2025050706570866000_lvaf077-B33","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1093\/humrep\/dep360","article-title":"An internet-based prospective study of body size and time-to-pregnancy","volume":"25","author":"Wise","year":"2010","journal-title":"Hum Reprod"},{"issue":"3","key":"2025050706570866000_lvaf077-B34","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.jhep.2023.04.035","article-title":"A global research priority agenda to advance public health responses to fatty liver disease","volume":"79","author":"Lazarus","year":"2023","journal-title":"J Hepatol"},{"issue":"6","key":"2025050706570866000_lvaf077-B35","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"issue":"7","key":"2025050706570866000_lvaf077-B36","doi-asserted-by":"publisher","first-page":"e00194","DOI":"10.1097\/HC9.0000000000000194","article-title":"Cause-specific mortality among patients with cirrhosis in a population-based cohort study in Ontario (2000-2017)","volume":"7","author":"Wang","year":"2023","journal-title":"Hepatol Commun"},{"issue":"3","key":"2025050706570866000_lvaf077-B37","doi-asserted-by":"publisher","first-page":"871","DOI":"10.3390\/cancers15030871","article-title":"Risk of cancer in patients with inflammatory bowel diseases and keys for patient management","volume":"15","author":"Laredo","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2025050706570866000_lvaf077-B38","author":"Authorities TDHaM"},{"issue":"10431","key":"2025050706570866000_lvaf077-B39","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults","volume":"403","author":"NCD Risk Factor Collaboration (NCD-RisC)","year":"2024","journal-title":"Lancet"},{"key":"2025050706570866000_lvaf077-B40","doi-asserted-by":"publisher","first-page":"1256116","DOI":"10.3389\/fpsyt.2024.1256116","article-title":"Obstructive sleep apnea and 19 gastrointestinal diseases: a Mendelian randomization study","volume":"15","author":"Yan","year":"2024","journal-title":"Front Psychiatry"},{"issue":"27","key":"2025050706570866000_lvaf077-B41","doi-asserted-by":"publisher","first-page":"4391","DOI":"10.1002\/sim.7501","article-title":"Practical recommendations for reporting Fine-Gray model analyses for competing risk data","volume":"36","author":"Austin","year":"2017","journal-title":"Stat Med"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejendo\/advance-article-pdf\/doi\/10.1093\/ejendo\/lvaf077\/62907115\/lvaf077.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/192\/5\/540\/62907115\/lvaf077.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejendo\/article-pdf\/192\/5\/540\/62907115\/lvaf077.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T10:57:18Z","timestamp":1746615438000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/192\/5\/540\/8110538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,10]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ejendo\/lvaf077","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,4,10]]}}}