S2787 Association Between Metabolic Dysfunction Associated Steatotic Liver Disease and Cardiovascular Disease in Inflammatory Bowel Disease: A Retrospective Analysis from a Tertiary Care Centre

Introduction: Cardiovascular disease (CVD) remains the leading cause of mortality worldwide. Emerging evidence suggests that both inflammatory bowel disease (IBD) and metabolic-dysfunction-associated-steatotic-liver-disease (MASLD) independently increase cardiovascular risk. However, the impact of MASLD on cardiovascular outcomes, specifically within the IBD population, is not well characterized. This study aimed to evaluate the prevalence of cardiovascular comorbidities in patients with IBD, with and without coexisting MASLD, to better understand additive risk and guide screening practices. Methods: We conducted a retrospective electronic medical record review of all adult patients (>18 years) with a diagnosis of IBD at a tertiary care center. Patients were divided into 2 groups: those with IBD alone and those with both IBD and imaging evidence of MASLD. Outcomes included cardiovascular associations between IBD and MASLD. Categorical variables were analyzed using chi-square or Fisher’s exact tests, and continuous variables with independent t-tests. Results: A total of 317 patients with IBD were included, with 125 (39.4%) having coexisting metabolic MASLD. Patients in the IBD + MASLD group were significantly older (mean 58.5 vs 53.0 years, P < 0.001). The prevalence of coronary artery disease (CAD) was significantly higher in patients with IBD and MASLD compared to IBD alone (16.0% vs 7.8%, P = 0.023). Similarly, hypertension (54.4% vs 39.6%, P = 0.010) and hyperlipidemia (69.6% vs 38.5%, P < 0.001) were more common in the IBD + MASLD group. Diabetes mellitus also showed a significant association (36.0% vs 14.1%, P < 0.001), as did cirrhosis (5.6% vs 1.6%, P = 0.044) and history of hypothyroidism (18.4% vs 9.9%, P = 0.029). There were no significant differences in the prevalence of heart failure (4.8% vs 3.1%, P = 0.451) or CVA/TIA (5.6% vs 2.6%, P = 0.172). Medication analysis revealed that patients with IBD + MASLD were more likely to be on statins (73.4% vs 26.6%, P < 0.001), ACE inhibitors/ARBs (87.5% vs 12.5%, P < 0.001), beta blockers (25.6% vs 14.6%, P = 0.014), and insulin (16.8% vs 4.2%, P < 0.001). Use of antiplatelets and anticoagulants did not differ significantly. Conclusion: We conclude that MASLD in IBD patients is associated with a significantly greater burden of cardiometabolic comorbidities and cardiovascular risk compared to those with IBD alone. These findings underscore the need for routine cardiovascular risk assessment and targeted interventions in this high-risk subgroup.