P259 Metabolic associated Liver Disease and sex as key factors of cardiovascular risk in Inflammatory Bowel Disease
García Mateo, S.(1,2);Martínez-Domínguez, S.J.(1,2);Ballesta Martínez, S.(3);Espinosa Rueda, J.(3);Tejero Justes, C.(3);Aso Gonzalvo, M.C.(1);Gallego Llera, B.(1);Alfambra Cabreja, E.(1);Baptista, P.M.(2,4);Nocito Colón , M.M.L.(5);Gargallo-Puyuelo , C.J.(1,2);Gomollón, F.(1,6,7);
(1)University Hospital Lozano Blesa, IBD Unit, Zaragoza, Spain;(2)IIS Aragón, Digestive Diseases, Zaragoza, Spain;(3)University Hospital Lozano Blesa, Neurology Unit, Zaragoza, Spain;(4)CIBERehd, Liver Diseases, Madrid, Spain;(5)University Hospital Lozano Blesa, Inmunology Unit, Zaragoza, Spain;(6)University of Zaragoza, Faculty of Medicine, Zaragoza, Spain;(7)ISS Aragón, Digestive Diseases, Zaragoza, Spain;
Background
Atherosclerosis is the main factor for the development of cardiovascular (CV) events. Patients with systemic inflammatory conditions such as inflammatory bowel disease (IBD) are supposed to be at risk of early atherosclerosis. However, data are still contentious. IBD patients are also at risk of other comorbidities such as metabolic associated fatty liver disease (MAFLD), a well-recognised entity associated with increased CV risk. The aim of this study is to demonstrate the impact of MAFLD on CV risk for IBD patients.
Methods
Prospective cohort study of consecutive IBD outpatients (Leonnard-Jones criteria, > 1 year) was performed from October 2020 to April 2021. Of 947 patients, 50 with IBD who met criteria for MAFLD and 50 with IBD and without MAFLD were matched by sex, age and IBD location. Patients with a previous diagnosis of CV disease, type II diabetes mellitus and under treatment for dyslipidaemia were excluded. Fatty liver disease (FLD) was diagnosed by ultrasonography, controlled attenuation parameter (CAP TM), fatty liver index (FLI), hepatic steatosis index (HSI) and lipid accumulation product (LAP). To assess early atherosclerosis, alterations in carotid artery intima-media thickness (CIMT) and SCORE as non-invasive CV risk test were performed in both groups. Statistical analysis was performed using SPSS, a binomial generalized linear model with logistic regression was performed, with CIMT alteration as dependent variable. For all tests a two-sided p value <0.05 was considered significant.
Results
Of 100 IBD patients included 51 (51%) were women with median age of 51.0 (41-59). There were 49 (49%) patients diagnosed of ulcerative colitis (UC) and 51 (51%) of Crohn’s disease (CD). Comorbidities and disease patient’s characteristics are shown in table 1. Most of the patients had an abnormal CIMT (58 (58%)). Of all the variables obtained, only female sex (OR (CI 95%) 3.322 (1.03-10); p=0.033) and MAFLD (OR (CI 95%) 5.05 (1.71-14.92); p=0.003)) were significatively associated with CIMT alterations. SCORE test did not associate with a significatively CIMT alteration. Among the different options to assess FLD, only ultrasonography and CAP were statisticaly associated with CIMT alterations (specificity 66%, sensibility 62%, p=0.005).
Conclusion
Female sex and MAFLD are associated with early atherosclerosis defined by CIMT alterations in IBD patients. Ultrasonography and CAP are better than biochemical test not only to predict FLD but also to assess CV risk.