Epidemiology of metabolic syndrome in patients with inflammatory bowel disease: a population-level cohort study from the United States

Aakash Desai; Himsikhar Khataniar; Jana G. Hashash; Priya Sehgal; Francis A. Farraye; Gursimran S. Kochhar

Authors Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar.

Abstract

Background Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

Methods A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn’s disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

Results Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply with age (12-14% at 18-39 to 47-50% at ≥65) and was higher in men than women. Rates were greatest among American Indian (CD 45.2%), Black (40%) and Hispanic (38-39%) populations, and lowest in Asian patients (26%). MetS clustered with more severe phenotypes (stricturing CD, prior CD surgery) and was not elevated among patients receiving advanced therapy. MetS was associated with greater systemic corticosteroid use and higher surgery/colectomy risk, while stricture and fistula risks in CD were similar; advanced
therapy was not initiated more frequently in CD.

Conclusion Our study provides updated epidemiological estimates of MetS in patients with IBD in the US.

Keywords Inflammatory bowel disease, ulcerative colitis, Crohn’s disease, metabolic syndrome, epidemiology

Ann Gastroenterol 2025; 38 (6): 618-628