A162 OBESITY IS A RISK FACTOR FOR THE DEVELOPMENT OF THE EXTRAINTESTINAL MANIFESTATIONS IN ULCERATIVE COLITIS, BUT NOT IN CROHN’S DISEASE

Abstract

Abstract Background Several inflammatory markers have been associated with both obesity and the risk of adverse outcomes. Studies exploring obesity as a potential risk factor in extraintestinal manifestations (EIMs) development in patients with inflammatory bowel disease (IBD) are limited. Aims To describe the relationship between obesity and EIMs development, taking into consideration various confounding risk factors. Methods We performed a retrospective cohort study using data of 5,023 IBD patients diagnosed between 1954 and 2020. We collected data on demographics, clinical features, biochemistry, medications, smoking, weight status and EIMs (hepatobiliary, musculoskeletal, dermatological, urogenital, ophthalmological, and pulmonary). Obesity was defined as measured BMI≥30.00 kg/m2, prolonged steroid use – as using any corticosteroid formulations for at least 6 months. Rates were compared using Pearson’s chi-squared test with Bonferroni’s p-value adjustment. Univariate and multivariate logistic regression models were used to determine the association between obesity, potential contributing factors and EIMs. Results Data of 2,367 ulcerative colitis (UC) patients (47.8% females) and 2,656 Crohn’s disease (CD) patients (52.2% females), aged 18–97 (median 48.0, IQR 27.0) years, were analysed. Obesity was common among IBD patients (30.1%; 95% CI 28.7–31.6%) and the rate was higher than the Alberta’s population-based one (28.2%; 95% CI 28.17–28.23%); p=0.013. Obesity was less prevalent in the UC (28.5%; 95% CI 26.3–30.6%) vs CD cohort (31.4%; 95% CI 29.4–33.4%); p=0.049. In both cohorts, the EIMs prevalence tended to be slightly higher among IBD patients living with obesity compared to those without it (UC: 19.5% vs 16.1%, p=0.106; CD: 20.2% vs. 19.6%, p=0.767); the prevalence of specific EIMs subtypes and the proportion of IBD patients with over 2 or 3 EIMs also did not differ significantly. Among UC patients, obesity was proven to be a risk factor for EIMs development (OR 1.75, 95% CI 1.15–2.67; p=0.009), along with male sex (OR 1.90, 95% CI 1.25–2.89; p=0.02), and prolonged steroid use (OR 1.88, 95% CI 1.03–3.45; p=0.04). Among CD patients, logistic regression analysis showed that stricturing and penetrating disease behaviour (OR 1.69, 95% CI 1.04–2.75; p=0.033), iron deficiency (OR 1.55, 95% CI 1.16–2.07; p=0.003) and calcium deficiency (OR 2.43, 95% CI 1.36–4.36; p=0.003) were associated with EIMs development; obesity was not an independent or adjusted risk factor (Table). Conclusions In a large IBD cohort, obesity prevalence was found to be higher than in the general population. Interestingly, obesity was established as a risk factor for the EIMs development in UC, but not in CD. Our findings highlight the need for timely assessment and management of obesity in these disorders, which may help in preventing EIMs development. Funding Agencies AbbVie