S1729 Prevalence and Impact of Prediabetes on Cardiovascular and Cerebrovascular Outcomes in Inflammatory Bowel Disease: A Population-Based Nationwide Analysis (2022)

Introduction: While inflammatory bowel disease (IBD) is known to increase cardiovascular risk and its association with diabetes has been evaluated before, large-scale data on the burden and impact of prediabetes (pDM) in this population remain unclear. This study aimed to evaluate the burden of pDM in IBD-related hospitalizations and its association with cardiovascular and cerebrovascular events using a population-based analysis. Methods: Using International Classification of Diseases-10 codes, we conducted a retrospective analysis of the 2022 National Inpatient Sample (NIS) including adult IBD hospitalizations without established diabetes. Patients were stratified by pDM status. Baseline demographics and comorbidities were compared, and multivariable logistic regression assessed odds ratios (OR) for acute myocardial infarction (AMI), ischemic stroke (AIS), atrial fibrillation (AF), venous thromboembolism (VTE), cardiac arrest, and in-hospital mortality. Subgroup analysis was performed for younger [18-44] IBD patients. A P value < 0.05 was considered statistically significant. Results: Of 259,505 adult IBD hospitalizations, 3,220 (1.2%) had a concurrent diagnosis of pDM. Patients with pDM were older (median age 63 vs 54), more likely to be men (46.1% vs 42.8%), and had higher prevalence among Black (14.4% vs 11.2%) and Hispanic (11.3% vs 7.1%) groups. Patients with pDM had higher comorbidity burdens, including chronic pulmonary disease (25.3% vs 19.6%), complicated hypertension (18.1% vs 13.9%), and smoking history (43.1% vs 37.1%). In the full cohort, pDM was independently associated with increased odds of AMI (OR 1.91; 95% CI: 1.29-2.82; P < 0.001) and AIS (OR 2.14; 95% CI: 1.25-3.67; P = 0.006). Other outcomes including AF, VTE, cardiac arrest, and in-hospital mortality were not significantly different. Among younger patients, no outcome reached significance, though AIS showed a trend (OR 6.88; P = 0.052). Conclusion: Prediabetes is uncommon among IBD hospitalizations but is associated with significantly increased cardiovascular and cerebrovascular risk. These findings highlight the importance of early metabolic risk screening and intervention in this population.