bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1219 Late onset inflammatory bowel disease (IBD): Experience from two tertiary centers in Greece
Authors: Ioannou A , Theocharis G , Geramoutsos G , Sotiropoulos C , Koumentakis C , Leonidakis G , Pardalis P , Pantelakis E , Thomopoulos K , Michopoulos S , Zampeli E 
Published: January 2025

Abstract

Background
The incidence of IBD in the elderly has increased in recent years1. Aim of the study was the reporting of disease and patient characteristics when IBD diagnosis was set after 60 years.

Methods
Data were retrieved retrospectively from patients’ medical records and included demographics, disease phenotype, types of treatment and mortality.

Results
Of 1017 registered patients, 133 were diagnosed ≥60 years (13.08%). 87 (65.4%) men, mean age at diagnosis 67.7 years (range 61-83). 74 with Crohn's disease (CD) (55.6%): 34 (45.9%) ileal disease (L1), 22 (29.7%) ileocolic (L3), 18 (24.3%) colonic disease (L2). 68 (91.9%) patients had inflammatory phenotype and 6 (8.1%) perianal disease. Of 59 patients with ulcerative colitis (UC), 30 (50.8%) had extensive disease (E3), 24 (40.7%) left sided colitis (E2) and 5 (8.5%) proctitis (E1). 57 (42.9%) patients were treated with mesalamine. 76 patients (57.1%) required biologic therapy: 25 (32.9%) anti-TNFs, 30 (39.5%) vedolizumab and 21(27.6%) ustekinumab. 27 (20.3%) patients underwent surgery for the disease. Co-morbidities: 74 patients (55.6%) suffered with arterial hypertension, 42 (31.5%) dyslipidemia, 33 (24.8%) diabetes mellitus and 19 (14.2%) coronary heart disease. Between the years 2014 - 2024 12 patients were deceased [8M/4F, median age 75.8 years (R65-85)]. 7 with ulcerative colitis (UC) and 5 with CD. The mortality rate in this population was 1.17%. The registered causes of death were: 5/12 (41.7%) malignancy, 4/12 (33.4%) cardiac events, 1/12 (8.3%) infection, 1/12 (8.3%) gastrointestinal cancer and 1/12 (8.3%) other causes.

Conclusion
1) Less than 15% of patients were diagnosed with IBD after 60 years in a population from two tertiary centers 2) The majority required biologic therapy. 3) Mesalamine and vedolizumab were the most frequently administered drugs. 4) One fifth required surgery for their disease. 5) Co-morbidities were recorded in almost all cases. 6)Mortality rate was relatively low and the two leading causes of death were malignancies and cardiovascular events.

References
1.Nimmons D, Limdi JK. Elderly patients and inflammatory bowel disease. World J Gastrointest Pharmacol Ther. 2016 Feb 6;7(1):51-65. doi: 10.4292/wjgpt.v7.i1.51. PMID: 26855812; PMCID: PMC4734955.
P1220 Circulating Metabolite Signatures Linking Physical Activity to Inflammatory Bowel Disease Risk and Interactions with Genetic Susceptibility
Authors: He Z , Sun Y , Huang H , Fu T , Yuan S , Larsson S C , Ludvigsson J F , Wang X , Magro F , Bai Y , Chen J 
Published: January 2025

Abstract

Background
Recent studies have demonstrated the protective effect of physical activity on incident IBD, but the underlying mechanism remain unclear. Here, large-scale circulating metabolomics data was used to identify a metabolic signature reflecting moderate-to-vigorous physical activity (MVPA). We then investigated whether this signature mediated the association between MVPA and inflammatory bowel diseases (IBD) risk and how genetic susceptibility to IBD played roles in the association.

Methods
The present study was conducted in two prospective cohorts: the UK Biobank (n=194,292 for prospective analysis, n=12,766 for identification of the metabolic signature) and the Whitehall II study (n=5,925 for validation of the metabolic signature). MVPA in minutes per day was assessed by questionnaires and the circulating metabolome was profiled using a high-throughput nuclear magnetic resonance (NMR)-based platform. Associations between MVPA and individual metabolites were assessed using multivariable linear models and the MVPA-related metabolic signature was identified using elastic net regression. The primary analyses evaluated the prospective associations between MVPA/metabolic signature and incident IBD using multivariable Cox proportional hazards regression, and further examined the mediation role of the metabolic signature and the interaction with genetic susceptibility to IBD.

Results
We identified 100 metabolites significantly associated with MVPA, with a combination of 25 metabolites selected comprising the metabolic signature. During a mean follow-up of 13.3 years, 1,259 incident IBD cases were documented. Both MVPA and metabolic signature were associated with reduced incident IBD, with hazard ratio [HR] of 0.77 (95%CI, 0.66-0.90) and 0.60 (95%CI, 0.51- 0.71) for highest quartile vs. lowest quartile, respectively. The MVPA-related metabolic signature mediated 15.2% of the inverse association between MVPA and IBD risk. Participants with low MVPA/ metabolic signature and high genetic risk showed the highest IBD incidence, with both additive and multiplicative interactions observed.

Conclusion
The identified metabolic signature reflecting MVPA was found to mediate the inverse association between MPVA and incident IBD. Measuring a specific set of metabolites representative of MVPA, together with genetic susceptibility, may identify individuals with higher risk of IBD.
P1221 Microscopic colitis and risk of venous thromboembolism: A nationwide matched cohort study
Authors: Forss MD PhD A , Bröms G , Bergman D , Thuresson M , Sun J , Eriksson C , Olén O , Zöller B , Ludvigsson J F 
Published: January 2025

Abstract

Background
Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, have been associated with an increased risk of venous thromboembolism (VTE). However, data on VTE is lacking in large population-based cohorts of microscopic colitis (MC). We aimed to investigate the association between MC and VTE.

Methods
We included all Swedish adults (≥18 years) with MC without previous VTE (1990-2017, n=12,489, follow-up until 2021). MC and subtypes (collagenous colitis and lymphocytic colitis) were defined from prospectively recorded colorectal histopathology reports from all 28 pathology departments in Sweden. MC patients were matched for age, sex, calendar year and county of residence with up to five reference individuals (n=55,809) without MC or previous VTE from the general population. Sensitivity analyses included full sibling comparisons and stricter definition of VTE requiring a primary diagnosis of VTE. Incidence rates and multivariable-adjusted hazard ratios (aHRs) with 95% confidence interval (CI) were calculated using Cox proportional hazards modelling.

Results
Over a median of 10.0 years of follow-up, 755 (6.0%; 11.3/1000 person-years [95%CI 10.5-12.1]) VTE events occurred in individuals with MC and 2674 (4.8%; 8.6/1000 person-years [8.3-8.9]) in reference individuals. Individuals with MC had a higher overall relative risk of any VTE event compared with reference individuals (aHR 1.21 [1.11-1.32]), including higher risk of pulmonary embolism (aHR 1.23 [1.08-1.40]), deep vein thrombosis of the legs (aHR 1.16 [1.03-1.32), and other VTE events (aHR 1.31 [1.08-1.58]). Compared to full siblings, individuals with MC showed numerically, but statistically non-significant, higher relative risk of VTE (aHR 1.15 [0.98-1.35]). Restricting the outcome definition to VTE diagnoses recorded as the primary diagnosis, the estimate of any VTE event was similar for MC overall (aHR 1.26 [1.15-1.39]). In the stratified analyses of VTE there were no major differences in sex, age group, follow-up time, year of MC diagnosis, country of birth, and presence/absence of celiac disease diagnosis at the index date.

Conclusion
In this population-based study, individuals with MC had a 21% higher risk of VTE compared with reference individuals from the general population, equal to one extra VTE event for every 37 MC individuals followed for ten years.
P1223 Maternal dietary patterns during pregnancy and offspring’s risk of paediatric Inflammatory Bowel Disease - a cohort study
Authors: Anneberg MSc O M R , Halldórsson Þ I , Olsen S F , Bjerregaard A A , Hansen A V , Jess T , De Freitas M B 
Published: January 2025

Abstract

Background
The association between maternal dietary patterns during pregnancy and offspring’s risk of paediatric-onset inflammatory bowel disease (pIBD) is largely unknown. Therefore, we explored this link in mother-child dyads from the Danish National Birth Cohort (DNBC).

Methods
The DNBC is a nationwide cohort of pregnant mothers from Denmark enrolled between 1996 and 2002. In gestational week 25, a food frequency questionnaire assessed maternal intakes of &gt;360 foods during the previous four weeks. The foods were divided into 37 groups, and intakes of the food groups (g/day) were z-score normalised to make them comparable. K-means cluster analysis determined maternal dietary patterns by grouping mother-child dyads into mutually exclusive clusters based on maternal intakes of the 37 food groups. The children were followed from birth to their 18-year birthday through national patient registries using their personal identification number. Medical information from the registries was used to identify the children who developed pIBD, defined as ≤18 years of age when they received their first IBD diagnosis (n=182). Cox proportional hazards model analysed associations of maternal dietary patterns with offspring’s hazard ratios (HR) for pIBD, using the most common pattern as the reference. Analyses were adjusted for parental IBD diagnosis and maternal educational level, gestational weight gain, smoking, energy intake, nutritional supplement use, and antibiotics use.

Results
The study included 63,877 singleton mother-child dyads from the DNBC. K-means cluster analysis identified five dietary patterns among the mothers: a diverse dietary pattern (n=16,386), a Western-like dietary pattern (n=22,901), a plant-rich dietary pattern (n=17,541), an animal-based dietary pattern (n=4,473), and a non-recommended dietary pattern (n=2,576). Mothers with a diverse dietary pattern had high intakes of most food groups, especially meat, fish, vegetables, fruits, potatoes, desserts, and legumes. This dietary pattern reduced offspring’s risk of pIBD by 44% compared to the Western-like dietary pattern (HR 0.56; 95% CI: 0.35-0.91), which was attributed to a decreased risk of Crohn’s disease (HR 0.41; 95% CI: 0.22-0.76) but not ulcerative colitis (HR 0.73; 95% CI: 0.38-1.39). No associations with pIBD were found for the plant-rich, animal-based, and non-recommended dietary patterns compared to the Western-like dietary pattern (p &gt; 0.05).

Conclusion
In this prospective cohort study, we found that adhering to a diverse diet during pregnancy, characterised by high intakes of various food groups, protects the offspring against pIBD. Future studies should explore whether specific food groups or nutrients drive this association.
P1224 Bidirectional association between sleep pattern and inflammatory bowel disease: a large population-based prospective cohort study
Authors: Le K , Liu Y , Bai R , Sheng J , Zhu J , Xie S , Ma D , Liu Z 
Published: January 2025

Abstract

Background
Disturbances in sleep have been associated with systemic inflammation and increased susceptibility to various chronic diseases. However, the specific mechanisms by which sleep influences plasma protein expression and contributes to the increased risk of inflammatory bowel disease (IBD) have not been fully elucidated.

Methods
We analysed data from 381,228 participants in the UK Biobank. Sleep was scored with chronotype, sleep duration, insomnia, and daytime sleepiness. Adjusted odds ratios (ORs) for prevalent IBD in unhealthy sleep patterns were estimated, as well as adjusted hazard ratios (HRs) for incident IBD by sleep patterns. A subset cohort of 40,392 participants was used for proteomic profiling, with differential expression analysis and weighted gene co-expression network analysis (WGCNA) conducted. A proteomic prognostic risk model was also established using the least absolute shrinkage and selection operator (LASSO)-Cox regression.

Results
Among the 381,228 participants in the clinical cohort, 100,622 (26.4%) had unhealthy sleep (sleep score 0-2) at baseline. Prevalent IBD was associated with increased odds of unhealthy sleep (OR = 1.250, 95% CI: 1.165-1.340, p &lt; 0.001, Figure 1). Participants with unhealthy sleep had a higher risk of incident IBD (HR = 1.237, 95% CI: 1.136-1.348, p &lt; 0.001). In the proteomic cohort, unhealthy sleep and IBD displayed 182 common differentially expressed proteins. Enrichment analysis revealed significant inflammatory pathways, including positive regulation of cytokine production and immune cell activation. WGCNA identified seven module eigengenes, with unhealthy sleep impacting IBD through cell activation and chemotaxis pathway and amino acid and organic acid metabolism. Incorporating protein biomarkers enhanced the performance of predicted models that achieved an AUC of 0.81 for predicting 2-year IBD onset. Unhealthy sleep participants with high protein scores were at high risk of incident IBD (HR=3.370, 95% CI: 2.300-4.938, p &lt; 0.001), highlighting the importance of monitoring systemic inflammation.

Conclusion
Unhealthy sleep and IBD are bidirectionally linked, with inflammatory and metabolic proteins mediating the effect of poor sleep on IBD risk. Patients with sleep disturbances should be screened for inflammatory biomarkers to evaluate their IBD risk. Enhancing sleep quality may serve as an effective strategy for preventing and managing IBD.

References
Sleep disorders and inflammatory disease activity: chicken or the egg? Am J Gastroenterol. 2015 Apr;110(4):484-8.
P1234 Inflammatory Bowel Disease Trends and Advanced Therapy Utilization: Insights from the UAE
Authors: Ahmed H A , Swaid T K , Alzaabi M N , Khan S W , Ali A B A A , Tenaiji K S A A , Alahmad M A , Omar N M , Ahmed E F , Hosani I I A , Kumar K K C , Malik T A , Quraishi M N ,   SSMC
Published: January 2025

Abstract

Background
The Middle East is experiencing a rapid increase in inflammatory bowel disease (IBD) likely due to urbanization, dietary changes and environmental factors. The region lacks sufficient data, making it challenging to comprehend the full extent of IBD's impact on healthcare systems. This research aims to investigate IBD trends, disease behaviour, evolution and persistence of advanced therapy (AT) within a predominantly Arab patient population in UAE.

Methods
This observational study at a tertiary IBD centre in the UAE utilized the local IBD registry (prospective data collection from 2022). Data included disease characteristics, and AT usage. Descriptive statistics, regression models and Kaplan-Meier analysis were employed.

Results
Of the 859 IBD patients treated from 2012 to 2024, comprehensive data were available for 321 patients under active follow-up of which 64.2% comprised of Crohn’s disease (CD) and 35.8% with ulcerative colitis (UC). A ten-fold rise over a 22-year period in new diagnoses of IBD, particularly CD was observed. Median age at diagnosis was 25 years (IQR 25-42), with CD patients younger (24 years) than UC patients (28 years). Within CD, 20% had stricturing, 17% penetrating and 36% with perianal disease. 85% of CD and 61% of UC patients were exposed to at least one AT; 25% of CD and 18% of UC patients &gt;2 ATs, and 16% of CD and 11% of UC &gt;3 ATs. Infliximab and adalimumab were the main first-line ATs, while ustekinumab and risankizumab used in later AT lines. Ustekinumab and risankizumab, showed higher AT persistence compared to anti-TNFs. In CD, stricturing disease (p&lt;0.05), penetrating disease (p&lt;0.01), longer disease duration (p&lt;0.05), and younger age at diagnosis (p&lt;0.05) were linked to higher exposure to AT lines. In UC, younger age at diagnosis (p=0.001) was associated with increased number of AT exposures. Use of AT significantly changed between 2017–2020 and 2021–2024 (p&lt;0.001). Infliximab, adalimumab and vedolizumab were initially the most prevalent, with ustekinumab, risankizumab, and upadacitinib usage rising substantially by 2022. The time to initiate AT for CD and UC following diagnosis decreased significantly since 2017 by 6.82 and 6.91 months per year, respectively (p&lt;0.001), with a combined median time of 2.46 months (IQR 4.8) for CD for 2023-2024.

Conclusion
This is the first comprehensive evaluation of IBD in the UAE, highlighting a significant rise in new diagnoses, particularly CD with aggressive phenotypes, reflecting broader regional trends. AT utilization has evolved, with ustekinumab and risankizumab demonstrating better persistence and increasing adoption. These insights into disease patterns will help inform future regional healthcare policies.
P1235 COlombian PrevaLence of Extraintestinal Manifestations in Inflammatory bowel disease in an adult and pediatric cohort after evaluation by a multidisciplinary group COLEMI – study
Authors: Parra Izquierdo V , Frías-Ordoñez J , Puentes-Manosalva F , Sarmiento F , Garcia-Duperly R , Vargas M , Reyes G , Florez-Sarmiento C , Lobaton T 
Published: January 2025

Abstract

Background
Inflammatory Bowel Disease (IBD) is increasingly recognized as a systemic disorder, given its high prevalence of extra-intestinal manifestations (EIM) affecting various organs. The frequency of these manifestations varies depending on factors such as geographical region, IBD subtype, disease location, disease duration, and the timeliness of diagnosis, yet data on this topic remain limited in Latin America. This study aimed to assess the prevalence of the primary EIMs in IBD patients in Colombia, as well as to examine differences between Crohn's disease (CD) and ulcerative colitis (UC).

Methods
Prospective observational descriptive multicenter study in adult and pediatric patients with IBD of the Colombian IBD Foundation, with suspicious of EIM and after confirmed with by a multidisciplinary group in Colombia.

Results
A total of 266 out of 482 (55.1%) patients with inflammatory bowel disease (IBD) were suspected of having extra-intestinal manifestations (EIM) by their gastroenterologists, of which 197 (74.1%) were confirmed upon evaluation by a multidisciplinary team, resulting in an EIM prevalence of 40.9%, with a predominance of female patients (67.5%). Of the cohort, 95% were adults and 5% were pediatric patients, with 134/197 (68%) diagnosed with ulcerative colitis (UC) and 63/197 (32%) with Crohn's disease (CD), 49.2% of whom required biologic therapy. In UC patients, extensive colitis (E3) was the most common disease extension, while ileo-colonic (L3) involvement predominated in CD. The most frequent types of EIM were articular (36%), followed by cutaneous (34.5%) and ocular (24.9%) manifestations. The hospitalization rate due to IBD was 72.5%, with EIM present in 37.5% of UC patients and 52.5% of CD patients (Figure 1). Hepatobiliary manifestations (odds ratio [OR] = 1.931; 95% confidence interval [CI] 0.4311-13.66, p=0.44) were more common in UC compared to CD, whereas articular (OR=2.277; 95% CI 1.228-4.22), cutaneous (OR=1.027; 95% CI 0.5474-1.925), oral (OR=2.017; 95% CI 0.8727-4.661), and ocular (OR=2.683; 95% CI 1.374-5.23) manifestations were more frequent in CD (Figure 1). In terms of the number of EIMs, 71.5% of UC patients had one, 16% had two, and 12.5% had three or more, while in CD, 50.7% had one, 27% had two, and 22.2% had three or more. A higher prevalence of EIM was observed in the central region of the country (Figure 2).

Conclusion
The prevalence of EIM in this Colombian cohort was high (40,9%), predominating the CD, female, extensive disease and higher requirement for biologicals.
P1240 Overweight in patients with inflammatory bowel disease and the associated risk of malnutrition
Authors: Suarez Ferrer C J , Cubillo Garcia C , Garcia-Rojas Pleite C , Rueda Garcia J L , Martin Arraz E , Sanchez Azofra M , Poza Cordon J , Garcia Ramirez L , Noci Belda J , Martin-Arranz M D 
Published: January 2025

Abstract

Background
Although inflammatory bowel disease(IBD) has traditionally been associated with malnutrition,the prevalence of overweight(0W)and obesity is currently increasing.Moreover, both overweight and chronic inflammation can elevate the risk of essential micronutrient deficiencies.The objective of this study is to investigate the prevalence of OW in a cohort of IBD patients and the associated risk of nutritional deficiencies

Methods
This is a cross-sectional study that consecutively included patients attending the day hospital for intravenous biologic that didn’t fulfill exclusion criteria (e.g. short bowel syndrome or oral nutritional supplements).All patients underwent weight and height measurements,assessment of IBD clinical activity (Harvey-Bradshaw Index[HBI] for Crohn's disease and Walmsley Index[WI] for ulcerative colitis and completion of the MUST(Malnutrition Universal Screening Tool) questionnaire. A blood test was also performed to obtain a comprehensive nutritional profile, and fecal calprotectin(FC)levels were measured

Results
A total of 93 patients were included. Baseline characteristics are summarized in TABLE 1.Regarding body mass index(BMI), 2 patients(2.5%) had a BMI below 18.5, 45 (57%) were classified as normal weight(BMI 18.5-25), and 32 (40.5%) were OW(BMI over 25). No differences were found in clinical activity ( HBI or WI) between OW and normal-weight patients(p=0.75 and p=0.57, respectively).However, a lower mean FC level was observed in overweight patients(166.2 µg/g vs. 445.1 µg/g),though this difference did not reach statistical significance(p=0.18).Similarly, no significant differences in C-reactive protein levels were observed between the two groups(5.13 mg/L vs. 2.6 mg/L; p=0.09).There were also no differences in the type of IBD, disease location or the line of biologic treatment among patients with or without OW. OW IBD patients showed a statistically significant association with higher levels of prealbumin, hemoglobin, triglycerides, and ferritin.No greater micronutrient deficiencies were identified in overweight patients compared to those with normal weight. The laboratory profiles of both groups are summarized in TABLE 2.Regarding the risk of malnutrition, using the self-completed portion of the MUST questionnaire to minimize potential BMI bias, it was identified that only 20% of patients with intermediate/high risk of malnutrition were OW(p=0.04) ( vs normal-weight patients; p=0.04)

Conclusion
OW is common in IBD patients,even among those with active inflammation and refractory response to advanced treatments. In our experience,OW IBD patients do not exhibit greater micronutrient deficiencies compared to normal-weight patients,though they do present characteristic laboratory alterations associated with OW