Inflammatory Bowel Disease and Risk of Global Cardiovascular Diseases and Type 2 Diabetes

Zhengbao Zhu; Yiming Jia; Fu-Rong Li; Yang Li; Li-Hua Chen; Huan-Huan Yang; Daoxia Guo; Lulu Sun; Mengyao Shi; Tao Wang; Thomas E Rohan; Qibin Qi; Li-Qiang Qin; Yonghong Zhang; Guo-Chong Chen

doi:10.1093/ibd/izad163

Inflammatory Bowel Disease and Risk of Global Cardiovascular Diseases and Type 2 Diabetes

Inflamm Bowel Dis. 2023 Aug 14:izad163. doi: 10.1093/ibd/izad163. Online ahead of print.

Authors

Zhengbao Zhu^{1

2}, Yiming Jia¹, Fu-Rong Li³, Yang Li⁴, Li-Hua Chen⁵, Huan-Huan Yang⁶, Daoxia Guo^{1

7}, Lulu Sun¹, Mengyao Shi^{1

2}, Tao Wang⁴, Thomas E Rohan⁴, Qibin Qi⁴, Li-Qiang Qin⁸, Yonghong Zhang¹, Guo-Chong Chen⁸

Affiliations

¹ Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China.
² Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
³ School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China.
⁴ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
⁵ Department of Nutrition and Food Hygiene, School of Public Health, Nantong University, Nantong, China.
⁶ Vanke School of Public Health, Tsinghua University, Beijing, China.
⁷ School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.
⁸ Department of Nutrition and Food Hygiene, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China.

PMID: 37579307
DOI: 10.1093/ibd/izad163

Abstract

Background: Inflammatory bowel disease (IBD) was associated with elevated risk of cardiometabolic diseases in observational studies. We aimed to evaluate the observational and genetic associations of Crohn's disease (CD) and ulcerative colitis (UC) with multiple cardiometabolic outcomes.

Methods: Our phenotypic and genetic association analyses included more than 400 000 participants who were free of major cardiovascular disease and diabetes at recruitment (2006-2010) and were followed up until December 2019 based on the UK Biobank. For the Mendelian randomization (MR) analyses, 415 and 273 single nucleotide polymorphisms associated with CD and UC, respectively, were selected as genetic instruments. Summary-level data on individual cardiometabolic outcomes were obtained from 4 different genome-wide association studies with a total of 2 248 842 participants.

Results: In the multivariable-adjusted observational analyses, CD was associated with higher risks of heart failure (hazard ratio [HR], 1.72; 95% confidence interval, 1.22-2.42) and type 2 diabetes (HR, 2.11; 95% confidence interval, 1.67-2.67) but not with myocardial infarction or ischemic stroke. UC was related to increased risks of all the assessed cardiometabolic diseases (HRs ranged from 1.29 for myocardial infarction to 1.76 for type 2 diabetes). Conversely, neither the genetic risk score for CD nor that for UC was associated with higher risk of developing cardiometabolic diseases. In 2-sample MR analyses, genetically determined CD and UC were not associated with any of the assessed cardiometabolic diseases (all P values >.05).

Conclusions: Despite confirming the observational associations, our study does not support a causal association between IBD and elevated risk of cardiometabolic diseases.

Keywords: Crohn’s disease; cardiovascular disease; causality; type 2 diabetes; ulcerative colitis.

Abstract

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