P2695 - The Correlation Between Visceral Abdominal and Total Adipose Tissue With Metabolic Risk Factors in Patients With Inflammatory Bowel Diseases

Tuesday, October 26, 2021

10:30 AM – 4:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Andres Yarur, MD

Medical College of Wisconsin
Milwaukee, WI, United States

Andres Yarur, MD¹, Lizbeth Nunez, CCRC¹, Brandon E. Berens, BS, CCRC¹, Andrea Moosreiner, MHD, RD¹, Matthew Wiesner, BS¹, Parakkal Deepak, MBBS, MS, FACG², Shaina Sekhri, MD¹, Poonam Beniwal-Patel, MD¹, Edward V. Loftus, MD, FACG³, Alexandra Bruss, BS¹
¹Medical College of Wisconsin, Milwaukee, WI; ²Washington University School of Medicine in St. Louis, St. Louis, MO; ³Mayo Clinic, Rochester, MN

Introduction: Visceral adipose tissue (VAT) is strongly associated with cardiovascular outcomes and serum lipoproteins in the general population. The degree of correlation in patients with inflammatory bowel diseases (IBD) is unknown, but vital to understand, as they have higher risk of cardiovascular events, and novel drugs may negatively affect lipoprotein profiles. The aim of the study was to assess the association between VAT% and total adipose tissue (TAT)% with several metabolic risk factors.

Methods: We performed a prospective cross-sectional study included patients with IBD. Patients on any pharmacologic therapy known to affect lipoprotein levels were excluded. After informed consent, we collected clinical data, biomarkers (C-reactive protein [CRP] and fecal calprotectin [FCP]) and endoscopic disease activity using Mayo or SES-CD scores. Physical activity was graded using the RAPA score. Body composition parameters were measured using a GE iDXA scan. Outcomes were serum lipoproteins, hypertension, diabetes and non-alcoholic steatohepatitis (NASH). Multiple regression models were performed to assess the association between body composition parameters and outcomes.

Results: A total of 152 IBD patients were included. There was a strong correlation between lipoprotein level and VAT% (Table 1). There was a weak correlation between VAT (but not TAT) and CRP but no correlation with FCP levels. No association was seen between IBD phenotype, therapy or disease activity and VAT/TAT% (p >0.05 for all). Total, LDL and remnant cholesterol levels were significantly higher on those patients with higher VAT% (Figure 1A-1D). Patients with hypertension and/or diabetes had higher a VAT% and SAT% (p< 0.0001 and p< 0.05, respectively). Moreover, patients with NASH had a higher VAT% (p< 0.001) but not a significantly different SAT% (p=0.2). After adjusting for age, gender and smoking status, patients in the highest 2 quartiles of VAT% had six-fold higher chance (OR: 5.5 [95%CI: 1.6-18.5], p=0.006) of presenting with abnormal LDL levels (≥100 mg/dL) and a five-fold higher chance (OR:4.7 [95%CI: 1.2-17.5], p=0.02) of having a high total cholesterol (≥200 mg/dL).

Discussion: Although both TAT and VAT% were correlated with metabolic risk factors in IBD patients, VAT% remained independently and more strongly associated with an adverse metabolic risk profile. Potential interventions to improve body composition profiles in IBD patients as well as a more aggressive screening and treatment may be warranted.

Figure: Figure 1: Difference in lipoproteins among visceral adipose tissue quartiles in an inflammatory bowel disease population

	VAT% All rho (p value)	VAT% Men rho (p value)	VAT% Women rho (p value)	TAT% All rho (p value)	TAT% Men rho (p value)	TAT% Women rho (p value)
Age	0.61 (< 0.0001)	0.69 (< 0.0001)	0.57 (< 0.0001)	0.28 (< 0.001)	0.37 (0.004)	0.32 (0.002)
Total Cholesterol	0.5 (< 0.0001)	0.68 (< 0.0001)	0.35 (0.001)	0.25 (< 0.01)	0.41 (0.03)	0.3 (0.006)
LDL Cholesterol	0.51 (< 0.0001)	0.64 (< 0.0001)	0.38 (< 0.001)	0.2 (0.02)	0.3 (0.03)	0.34 (0.002)
HDL Cholesterol	-0.17 (0.05)	-0.03 (0.82)	-0.2 (0.07)	0.06 (0.5)	0.08 (0.57)	-0.08 (0.48)
Triglycerides	0.5 (< 0.0001)	0.5 (< 0.0001)	0.46 (< 0.0001)	0.28 (0.001)	0.42 (0.002)	0.3 (0.007)
Remnant Cholesterol	0.47 (< 0.0001)	0.54 (< 0.0001)	0.42 (< 0.0001)	0.27 (0.001)	0.45 (< 0.001)	0.27 (0.014)
Waist-hip ratio	0.61 (< 0.0001)	0.68 (< 0.0001)	-0.56 (< 0.0001)	0.28 (< 0.01)	0.48 (< 0.001)	0.4 (< 0.001)
Body Mass Index	0.7 (< 0.0001)	0.7 (< 0.0001)	0.75 (< 0.0001)	0.73 (< 0.0001)	0.82 (< 0.0001)	0.84 (< 0.001)
Physical activity (RAPA score)	-0.063 (0.45)	-0.17 (0.2)	-0.07 (0.5)	-0.2 (0.003)	-0.39 (0.003)	-0.14 (0.19)
C-Reactive protein	0.19 (0.03)	0.19 (0.16)	0.18 (0.1)	0.11 (0.2)	-0.003 (0.98)	0.2 (0.05)
Fecal calprotectin	0.06 (0.72)	0.2 (0.45)	-0.06 (0.8)	0.02 (0.91)	0.46 (0.06)	-0.27 (0.2)

Table: Table 1: Correlation between total and visceral adipose tissue, cardiometabolic factors, physical activity and inflammatory biomarkers. (VAT: visceral adipose tissue, TAT: total adipose tissue)

Disclosures:

Andres Yarur: Arena – Advisory Committee/Board Member, Consultant. Bristol Myers Scribb – Consultant. Prometheus Labs – Consultant. Takeda – Advisory Committee/Board Member, Grant/Research Support.

Lizbeth Nunez indicated no relevant financial relationships.

Brandon Berens indicated no relevant financial relationships.

Andrea Moosreiner indicated no relevant financial relationships.

Matthew Wiesner indicated no relevant financial relationships.

Parakkal Deepak: Abbvie – Advisory Committee/Board Member. Arena Pharmaceuticals – Advisory Committee/Board Member, Grant/Research Support. Boehringer Ingelheim – Consultant, Grant/Research Support. Bristol-Myers Squibb-Celgene – Advisory Committee/Board Member, Grant/Research Support. Janssen Pharrmaceuticals – Advisory Committee/Board Member. Pfizer – Advisory Committee/Board Member. Prometheus Biosciences – Advisory Committee/Board Member. Takeda Pharmaceuticals LLC – Grant/Research Support.

Shaina Sekhri indicated no relevant financial relationships.

Poonam Beniwal-Patel indicated no relevant financial relationships.

Edward Loftus: AbbVie – Advisory Committee/Board Member, Consultant, Grant/Research Support. Amgen – Consultant. Arena – Consultant. Boehringer Ingelheim – Consultant. Bristol-Myers Squibb – Advisory Committee/Board Member, Consultant, Grant/Research Support. Calibr – Consultant. Celgene – Advisory Committee/Board Member, Consultant, Grant/Research Support. Eli Lilly – Advisory Committee/Board Member. Genentech – Advisory Committee/Board Member, Consultant, Grant/Research Support. Gilead – Advisory Committee/Board Member, Consultant, Grant/Research Support. Iterative Scopes – Consultant. Janssen – Advisory Committee/Board Member, Consultant, Grant/Research Support. Ono Pharma – Consultant. Pfizer – Grant/Research Support. Receptos – Grant/Research Support. Robarts Clinical Trials – Grant/Research Support. Sun Pharma – Consultant. Takeda – Advisory Committee/Board Member, Consultant, Grant/Research Support. Theravance – Grant/Research Support. UCB Pharma – Advisory Committee/Board Member, Consultant, Grant/Research Support.

Alexandra Bruss indicated no relevant financial relationships.