P684 Increased risk of cardiovascular disease and high risk profiles compatible with metabolic syndrome in patients with Inflammatory Bowel Disease: a cross-sectional analysis of matched cohorts

Abstract

Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of cardiovascular disease (CVD). This probably results from a cumulative effect of chronic inflammation and traditional CVD risk factors. We assessed the CVD risk profile of IBD patients as compared to the general population. Methods In this cross-sectional study, consecutive IBD patients aged ≥45 years were included at the Gastroenterology and Hepatology outpatient clinic. CVD risk profiles wese assessed by anthropometrics (blood pressure, length, weight, waist and hip circumference), serum analyses (nonfasting glucose and lipid spectrum) and self-administered questionnaires (history of CVD events, traditional CVD risk factors, medication use). One to four controls from the Rotterdam Study were matched to each IBD case by sex and age (scope +-5 years). Stratification was applied to asses differences between sex, IBD diagnosis and clinical disease activity (HBI or SCCAI>5). Results 235 IBD patients were included (44% male; median age 59 years (IQR 51–66)) and matched to 829 controls (44% male; median age 62 years (IQR 57–68)). IBD patients were more frequently diagnosed with CVD (OR 2.01, 95%CI 1.23–3.27). IBD patients showed lower odds of overweight defined as BMI ≥25 kg/m2 (OR 0.48, 95%CI 0.35–0.66) and hypercholesterolemia defined as total cholesterol ≥6.2 mmol/L, self-reported diagnosis or use of lipid lowering drugs (OR 0.45, 95%CI 0.31–0.65). The following markers of metabolic syndrome were increased in IBD patients: hypertension defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, self-reported diagnosis or use of antihypertensive drugs (OR 1.67, 95%CI 1.19–2.32), waist circumference (92 cm (SE±10) vs 88 cm (SE±8), p=.006) and triglyceride level (2.7 mmol/L (SE±0.8) vs 2.1 (SE±0.8), p<.001). (Table 1) Male patients had higher waist circumference, less favorable lipid profiles and were more frequently diagnosed with hypertension (OR 1.72, 95%CI 0.99–2.94) as compared to female patients. Patients with ulcerative colitis were more frequently smokers (OR 4.34, 95%CI 1.27–16.66) and showed higher odds of hypercholesterolemia (OR 1.85, 95%CI 1.06–3.33) as compared to patients with Crohn’s disease. Conclusion Patients with IBD are more frequently diagnosed with CVD as compared to age-sex matched controls. The CVD risk profile in IBD patients is characterized by components of the metabolic syndrome, i.e. hypertension, truncal obesity and hypertriglyceridemia, particularly among male IBD patients. The prevalence of other traditional CVD risk factors was comparable or even lower in IBD patients as compared to controls. The exploration of targeted preventive management strategies is required.