Systemic Antibiotics and Obesity: Analyses from a Population-Based Cohort

Background: In this study, we analyzed the association between antibiotic use and obesity and metabolic syndrome (MS) in a Korean adult population. Methods: Subjects using the Korean National Health Insurance Service sample cohort were retrospectively analyzed in 2015. The differences in obesity and metabolic syndrome (MS) status were compared and analyzed according to duration of systemic antibiotic treatment in the previous 10 years (non-users, 1st, 2nd, and 3rd tertile). Results: Subjects who used systemic antibiotics for longer periods were older, satisfied more criteria for MS, and had more comorbidities than non-users (non-users vs. 3rd tertile, p < 0.0001 for all). After adjusting for confounding factors, the risk of obesity was higher in subjects who used systemic antibiotics for longer periods than in non-users (non-users vs. 3rd tertile, OR (odds ratio) (95% CI (confidence interval)); 1.20 (1.12–1.38)). The criteria for MS were more satisfied in the 3rd tertile than in non-users. A higher obesity risk was also found in subjects treated with antibiotics targeting Gram-negative organisms than in those targeting Gram-positive organisms. Conclusion: The risk of obesity was higher in subjects who took systemic antibiotics more frequently. The risk was more prominent when they took antibiotics targeting Gram-negative bacteria.