B0626 - Metabolic Syndrome Is Not Associated With Mesenteric Ischemia

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Ameya Deshmukh, DO

Saint Louis University School of Medicine
St. Louis, MO

Ameya Deshmukh, DO¹, Abdul Mohammed, MD², Parth Desai, DO³, John Altomare, MD³
¹Saint Louis University School of Medicine, St. Louis, MO; ²Cleveland Clinic, Cleveland, OH; ³Tower Health - Reading Hospital, Reading, PA

Introduction: Metabolic syndrome (MetS) is an increasingly prevalent pathological condition with multiple components such as insulin resistance, hyperlipidemia and increased abdominal adiposity. MetS has previously been associated with increased risk of coronary artery disease (CAD), myocardial infarction (MI), stroke and diabetes. It has been well established with many atherosclerotic processes, however its impact on the development of mesenteric ischemia has not been studied. The purpose of this study is to evaluate if an association between mesenteric ischemia and MetS exists.

Methods: We queried a commercial database (Explorys Inc, Cleveland, OH) with electronic medical record data from 26 major U.S. healthcare systems. Adult patients ( >/=18 years old) with and without MetS between 1999 and 2021 were identified based on systematized nomenclature of medicine-Clinical Terms (SNOMED-CT). Differences in baseline characteristics and demographics were analyzed using chi-squared tests. Odds ratio analyses were performed between MetS and non-MetS patients for the presence of acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), coronary artery disease (CAD), peripheral vascular disease (PVD), myocardial infarction (MI), cerebrovascular accident (CVA). We defined P-values less than 0.05 to be statistically significant.

Results: A total of 102,360 individuals were found to with and without MetS in the database. Of those patients, 1360 (1.3%) had MetS. MetS patients were more likely to be under the age of 65 (35.3% vs 20.9%, P< 0.0001), more likely to be female (66.9% vs 63.6%, P=0.0399), identified more commonly as White (84.6% vs 80.8%, P< 0.0001) and were more likely to be smokers (86.8% vs 71.5%, P< 0.0001). MetS patients were more likely to have CAD (OR: 1.65, P< 0.0001), PVD (OR: 1.99, P< 0.0001), MI (OR: 1.42, P< 0.0001) and CVA (OR:1.44, P< 0.0001). There was no difference in acute or chronic mesenteric ischemia.

Discussion: This study found no association between MetS and mesenteric ischemia but did have similar findings relating to other established cardiovascular conditions in other studies. This suggests that another atherosclerotic mechanism exists which contributes to mesenteric ischemia, particularly chronic mesenteric ischemia.

Event	MetS (N=1,360)	MetS (%)	No MetS (N=101,000)	Non-MetS (%)	P-Value	Odds Ratio	CI (95%)
Acute mesenteric ischemia	540	39.7%	38,110	37.7%	0.1361	1.0867	0.9741, 1.2123
chronic mesenteric ischemia	300	22.1%	22,540	22.3%	0.8204	0.9852	0.8659, 1.1208
Coronary artery disease	710	52.2%	40,170	39.8%	< 0.0001	1.6541	1.4860, 1.8412
Peripheral arterial/vascular disease	960	70.6%	55,140	54.6%	< 0.0001	1.9961	1.7752, 2.2445
Myocardial infarction	390	28.7%	22,220	22.0%	< 0.0001	1.4255	1.2662, 1.6048
Stroke	490	36.0%	28,380	28.1%	< 0.0001	1.4412	1.2891, 1.6113

Characteristics
Female	910	66.9%	64,270	63.6%	0.0399
Male	450	33.1%	36,720	36.4%	0.1481
>65	880	64.7%	70,450	69.8%	0.0011
18-65	480	35.3%	21,150	20.9%	< 0.0001
White	1,150	84.6%	81,580	80.8%	0.0011
AA	150	11.0%	10,580	10.5%	0.8428
Asian	20	1.5%	1,340	1.3%	0.9376
Multirace	20	1.5%	910	0.9%	0.7803
Unknown	210	15.4%	13,210	13.1%	0.3276
Other	50	3.7%	2,450	2.4%	0.5543
Refused	30	2.2%	1,590	1.6%	0.796
Hispanic/Latino	N/A	N/A	610	0.6%	N/A
asian/pacific islander	N/A	N/A	180	0.2%	N/A
native america/alaskan native	N/A	N/A	120	0.1%	N/A
Cardiomyopathy	220	16.2%	10,430	10.3%	0.0046
CHF	470	34.6%	27,770	27.5%	0.0006
COPD	530	39.0%	31,960	31.6%	0.0003
HTN	1,250	91.9%	76,780	76.0%	< 0.0001
HLD	1,230	90.4%	65,310	64.7%	< 0.0001
DM	910	66.9%	34,430	34.1%	< 0.0001
CKD	600	44.1%	29,730	29.4%	< 0.0001
ESRD	160	11.8%	7140	7.1%	0.023
Presence of cirrhosis	140	10.3%	5,100	5.0%	0.0051
Alcohol abuse	80	5.9%	5,860	5.8%	0.9697
tobacco abuse/smoking	1,180	86.8%	72,240	71.5%	< 0.0001
Obesity	920	67.6%	23,330	23.1%	< 0.0001

Table: Comparison of Outcomes Between Metabolic Syndrome (MetS) and Non-Metabolic Syndrome (non-MetS) Patients.

Disclosures:

Ameya Deshmukh indicated no relevant financial relationships.

Abdul Mohammed indicated no relevant financial relationships.

Parth Desai indicated no relevant financial relationships.

John Altomare indicated no relevant financial relationships.

Ameya Deshmukh, DO¹, Abdul Mohammed, MD², Parth Desai, DO³, John Altomare, MD³. B0626 - Metabolic Syndrome Is Not Associated With Mesenteric Ischemia, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.