IDDF2024-ABS-0453 Long-term risk of colectomy associated with life’s essential 8 in ulcerative colitis patients: a prospective cohort study

<h3>Background</h3> The activity and severity of ulcerative colitis (UC) are associated with the need for colectomy. Life’s Essential 8 (LE8) index is a novel cardiovascular health measure potentially associated with inflammation. However, its impact on the risk of colectomy in UC patients is unknown. <h3>Methods</h3> We used Cox proportional hazards models and mediation analysis to examine the associations between LE8 index, inflammation score (INFLA-score), and colectomy among UK Biobank participants with a diagnosis of UC at baseline. LE8 index was evaluated at baseline and categorized into lower (LE8 score &lt;60) and higher (LE8 score ≥ 60) groups or into less (0~1 metrics of LE8 meeting 100 points) and more (≥ 2 metrics of LE8 meeting 100 points) groups. The outcome of colectomy was derived from the Office of Population Censuses and Surveys-4 (OPSC-4) codes. <h3>Results</h3> A total of 1,433 patients were included with an age of 57.3 ± 7.9 years and 52.8% males (IDDF2024-ABS-0453 Table 1). During a median follow-up of 14.4 years, 77 colectomy cases were documented. A higher LE8 score was associated with a significantly lower risk of colectomy (hazard ratio [HR]: 0.54; 95% confidence interval [CI]: 0.33, 0.90, P &lt; 0.05) (IDDF2024-ABS-0453 Table 2). Compared with participants with 0 or only 1 metrics of LE8 meeting 100 points, more than 2 metrics meeting 100 points were associated with a 50% lower risk of colostomy (HR: 0.50; 95% CI: 0.25, 0.99, P &lt; 0.05) (IDDF2024-ABS-0453 Figure 1), and subgroup analysis suggested a lower risk in male after adjusting age (HR: 0.43; 95%CI: 0.19, 0.99, P &lt; 0.05). Sensitivity analysis demonstrated the robustness of the association. INFLA-score mediated up to 26.18% of this association (P &lt; 0.05) (IDDF2024-ABS-0453 Figure 2). <h3>Conclusions</h3> Ideal LE8 score was associated with a lower risk of colectomy, with a more pronounced association observed in individuals with more than 2 metrics meeting 100 points, which is partially mediated by inflammation. Our findings highlight lifestyle management according to LE8 guidelines among UC patients, especially in males.