Impact of Inflammatory Bowel Disease (IBD) and IBD Medications on Risk of Hyperlipidemia and in vitro Hepatic Lipogenic-Related Gene Expression: A Population-Based Cohort Study

Ni Tien; Tien-Yuan Wu; Cheng-Li Lin; Chia-Jui Wu; Chung-Y Hsu; Yi-Jen Fang; Yun-Ping Lim

doi:10.3389/fmed.2022.910623

Impact of Inflammatory Bowel Disease (IBD) and IBD Medications on Risk of Hyperlipidemia and in vitro Hepatic Lipogenic-Related Gene Expression: A Population-Based Cohort Study

Front Med (Lausanne). 2022 Jun 13:9:910623. doi: 10.3389/fmed.2022.910623. eCollection 2022.

Authors

Ni Tien^{1

2}, Tien-Yuan Wu^{3

4}, Cheng-Li Lin⁵, Chia-Jui Wu⁶, Chung-Y Hsu⁷, Yi-Jen Fang^{8

9

10

11

12}, Yun-Ping Lim^{6

13

14}

Affiliations

¹ Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan.
² Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan.
³ Department of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
⁴ Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan.
⁵ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁶ Department of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan.
⁷ Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
⁸ Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁹ Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan.
¹⁰ Graduate Institute of Clinical Medicine, Department of Environmental Health, Kaohsiung Medical University, Kaohsiung, Taiwan.
¹¹ National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
¹² Digestive Disease Center, Show Chwan Memorial Hospital, Changhua, Taiwan.
¹³ Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
¹⁴ Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.

Abstract

Patients with inflammatory bowel disease (IBD) present a higher risk of developing cardiovascular diseases (CVDs) due to chronic inflammation, which plays an essential role in atherogenesis. Hyperlipidemia is another risk factor for CVDs; however, the association between IBD, IBD medications, and hyperlipidemia remains controversial. We conducted a nationwide, population-based, retrospective, cohort study to examine the effect of IBD and IBD medications on the risk of developing hyperlipidemia. The effects of IBD medications on the expression of lipogenesis-related hepatic genes were also evaluated. We obtained data from the Longitudinal Health Insurance Database of Taiwan from patients with new-onset IBD and a comparison cohort of patients without IBD. A Cox proportional hazards regression model was used to analyze the difference in the risk of developing hyperlipidemia between the two cohorts. We also examined the influence of IBD medications on the expression of lipogenesis-related hepatic genes. After adjusting for comorbidities and confounding factors, the case group (N = 14,524) had a higher risk for hyperlipidemia than the control group (N = 14,524) [adjusted hazards ratio (aHR), 2.18]. Patients with IBD that did not receive IBD medications exhibited a significantly higher risk of hyperlipidemia (aHR, 2.20). In those treated with IBD medications, the risk of developing hyperlipidemia was significantly lowered than those without such medications (all aHR ≤ 0.45). Gene expression analysis indicated that IBD medications downregulated the expression of lipogenesis-related genes. Screening blood lipids in IBD patients is needed to explore the specific role and impact of IBD medications in the development of CVD.

Keywords: IBD medications; Longitudinal Health Insurance Database (LHID); hyperlipidemia; inflammatory bowel disease (IBD); lipogenesis.