784 A Population-Based Analysis of Obesity, Metabolic Syndrome, and Cardiovascular Outcomes Among Patients With Inflammatory Bowel Disease in the National Health and Nutrition Examination Survey 2009-2010

Abstract

INTRODUCTION: Prior studies have reported high prevalence of obesity and metabolic syndrome in inflammatory bowel disease (IBD) pts, increasing the risk for stroke and coronary artery disease (CAD). Here, we compare the prevalence of obesity, metabolic syndrome and cardiovascular outcomes in IBD compared to non-IBD controls in a large, nationally representative United States (US) population, controlling for traditional risk factors and dietary habits. METHODS: IBD pts were identified in the National Health and Nutrition Examination Survey (NHANES) 2009-2010. This population-based survey combines data from pt interviews, physical exam, and lab tests. For analysis, obesity was defined as BMI ≥ 30 and metabolic syndrome by waist circumference, presence of diabetes, hypertension, and hyperlipidemia. IBD pts were propensity matched in a 1:5 ratio to non-IBD controls on age, gender, race, 26-item dietary screener questionnaire (DSQ), smoking, and alcohol usage. Cardiovascular outcomes analyzed included CAD, congestive heart failure (CHF), angina/angina pectoris, myocardial infarction (MI), and stroke with 1:5 propensity matching done on age, gender, race, BMI, body composition, presence of metabolic syndrome, DSQ items, smoking, and alcohol use. Raw data was extrapolated to the US population using provided sample weights and analyses performed using SAS 9.4. RESULTS: A total of 62 IBD pts were identified; 3 were excluded due to missing data. Baseline characteristics of the IBD (median age 54, 63% female, 46% white) and the propensity matched non-IBD group can be seen in Table 1. The prevalence of obesity in the IBD cohort was 34% compared to 41% in the non-IBD cohort, and when extrapolated to the U.S. population was not significant (P = 0.13). Similarly, the prevalence of metabolic syndrome in IBD compared to non-IBD, 43% to 45%, was not significant when extrapolated to the US population (P = 0.52). Comparing IBD to non-IBD controls (Table 2), there was no significant difference in prevalence of CAD (7.1% VS 4.4%, P = 0.45) or angina (3.6% vs 2.95, P = 0.97) while there was trend towards significance for stroke (8.9% vs 3.6%, P = 0.0599). CONCLUSION: Our findings suggest that when controlled for traditional risk factors and dietary habits, the prevalence of obesity, metabolic syndrome and cardiovascular disease in a nationally representative survey of self-reported IBD population in the US is similar to the non-IBD population.