Influence of metabolic syndrome on disease characteristics and activity in inflammatory bowel disease: A retrospective cohort study

The incidence of inflammatory bowel disease (IBD) and metabolic syndrome (MetS) has risen in recent years, but the relationship between the 2 remains understudied. This retrospective cohort study aimed to explore the impact of MetS on disease activity in IBD. Retrospective analysis of 676 consecutive IBD patients treated from January 2023 to April 2024. Study participants were stratified into a control cohort of 531 patients with uncomplicated IBD, and an exposure cohort of 145 patients with IBD and concurrent MetS. Data were collected and analyzed for all 676 patients at baseline and after 1-year follow-up. From an initial pool of 1730 potentially eligible patients, 156 (9%) were identified with MetS (IBD-MetS cohort: 86% ulcerative colitis and 14% Crohn's disease). Baseline clinical disease activity was significantly higher than in the IBD-only controls, with concomitant elevations in biomarkers including monocytosis, eosinophilia, elevated C-reactive protein and elevated erythrocyte sedimentation rate. At 12-months' follow-up, the IBD-MetS group showed significantly lower rates of clinical remission (54.48% vs 82.49%) and mucosal healing (24.83% vs 41.05%) compared to the controls. Inflammatory biomarkers remained elevated, consistent with baseline findings. After propensity score-matched analysis, a comparative analysis of 145 matched controls and 145 exposed groups showed that, compared to IBD-only patients, IBD-MetS patients still had significantly lower rates of clinical remission (54.48% vs 77.93%, odds ratio: 0.339, 95% confidence interval: 0.203-0.565, P < .001) and mucosal healing (24.83% vs 41.38%, odds ratio: 0.468, 95% confidence interval: 0.283-0.772, P = .003). Our findings indicate that MetS is correlated with increased disease activity in IBD. These findings emphasize the need for clinicians to identify and intervene in metabolic syndrome components in IBD patients, ultimately improving quality of life and providing new insights for future IBD-MetS research.