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P655 Insulin Resistance Prevalence is Not Increased in Patients with Inflammatory Bowel Disease: a case-control study

Carrillo Palau, M.(1);Hernández-Camba, A.(2);Hernández Álvarez-Buylla, N.(1);Ramos, L.(1);Alonso-Abreu, I.(1);Vela, M.(2);Hernández-Pérez, A.(1);Arranz, L.(2);Hernández-Guerra, M.(1);Ferraz-Amaro, I.(3);

(1)Hospital Universitario De Canarias, Gastroenterology, Santa Cruz De Tenerife, Spain;(2)Hospital Universitario Nuestra Señora de La Candelaria, Gastroenterology, Santa Cruz de Tenerife, Spain;(3)Hospital Universitario De Canarias, Reumathology, Santa Cruz De Tenerife, Spain

Background

Inflammatory bowel disease (IBD) is considered a chronic inflammatory state that has been associated with nonalcoholic fatty liver disease (NAFLD). Insulin resistance (IR) has been linked to NAFLD and inflammation. Whether if IR is prevalent in  IBD and increases the risk of NAFLD in these patients is unknown. We aimed to study if IR is prevalent in a cohort of patients with IBD and associated risk factors.

Methods

This multicentric cross-sectional study compared 151 IBD patients with 174 age matched non-diabetic controls. Insulin and C-peptide serum levels and IR and beta cell function (%B) indices by homoeostatic model assessment (HOMA2) were evaluated. In the IBD patients fatty liver disease (FLD) was assessed by ultrasound (Grade I-IV) and Transition elastography (Fibroscan ®, values were correlated to liver fibrosis as: <7.6 KPa=F0-F1, 7.7-9.4 KPa=F2, 9.5-14KpPa =F3, >14KPa =F4). .Anthropometric, IBD characteristics, biochemical parameters and concomitant diseases were registered as predictive factors for having IR among IBD patients and assessed by multivariable regression analysis.

Results

IBD patients (57% female, mean age 48 years(SD 10)), compared to matched controls (68% female, mean age 50 years(SD 16))  exhibited similar HOMA2-IR (0.97 ± 0.64 vs 1.31 ± 0.80, p=0.19) and HOMA2-%B indexes (126 ± 49 vs 134 ± 47, p=0.31) after adjusting by confounders. Obesity, abdominal circumference and triglycerides were associated with the presence of IR in IBD patients, whereas IBD  disease patterns, disease activity and inflammatory markers were not related to IR. Mild and moderate FLD  was present in 26% and 13 % of IBD patients, respectively.  FLD grades correlated with a higher insulin and C-peptide and IR indices as observed in the univariable analysis for HOM2-IR (0.06 (0.01-0.11)) and for HOM2-%B 6(3-10) indices.

Patients with severe fat infiltration  had higher serum levels of insulin and C-peptide and a superior HOM2-IR (2.4 ± 1.6, p=0.01) and HOMA2-%B (251 ± 40, p<0.001) indices compared to mild steatosis. Moreover, adjusted trend analysis showed significant values for C-peptide and HOMA2-%B, showing, therefore, that as FLD grades increases higher values of both also rises.

Conclusion

IBD patients show a similar prevalence of IR compared to controls. However, likewise in the general population, metabolic syndrome factors are associated with IR and FLD, so metabolic syndrome assessment is mandatory among IBD patients.

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