P0498 Relationship Of Disease Activation And Treatment With Pulmonary Function Tests And Obstructive Sleep Apnea Syndrome In Ulcerative Colitis Patients
Authors: Metin T , Balkan A , Emek H , Şahan M A 
Published: January 2025

Abstract

Background
Ulcerative colitis (UC) is a chronic disease with relapses and remissions that may also be associated with extra-intestinal pathologies (1). Patients may develop anemia due to chronic disease or bloody diarrhea, which may cause shortness of breath and limitation in exercise capacity (2). The aim of this study was to compare UC patients with healthy subjects and to determine the relationship between the presence of the disease, activation status and treatment with pulmonary function and obstructive sleep apnea syndrome (OSAS).

Methods
The study included 55 UC patients admitted to the Inflammatory Bowel Diseases (IBD) outpatient clinic of Gaziantep University School of Medicine within the last year and 55 healthy controls. Disease activation and endoscopic evaluation were based on Mayo score. Pulmonary function test, lung diffusion test (DLCO), MMRC score and six-minute walk test were performed in all participants. In the Berlin Questionnaire, the patient is questioned about the frequency and severity of snoring, the frequency of diagnosed apnea and the presence of hypertension or obesity. Each category is evaluated within itself and if two or more categories are positive, the risk of OSAS is considered high according to the Berlin questionnaire.

Results
In the control group, the rate of patients who exceeded 80% of the expectation in the six-minute walk test was higher than UC patients (p:0.001). MMRC score was significantly higher in UC patients compared to the control group (p:0.001). According to the Berlin questionnaire, 56.4% of UC patients were at high risk for OSAS, while this rate was 30.9% in the control group (p:0.007). FEV1 value was higher in UC patients who received biological agents compared to those who did not (p:0.041). As the endoscopic mayo score increased, patients were found to be at higher risk for OSAS in the Berlin questionnaire (p:0.002). UC patients with severe disease were more likely to be at high risk for OSAS than patients with mild and moderate disease (p:0.001). Although the MMRC score was numerically higher in patients with severe disease than in patients with mild and moderate disease, it was not statistically significant (p:0.065).

Conclusion
Extra-intestinal manifestations such as arthritis, uveitis are more recognised in UC, but respiratory pathologies are often overlooked (3). As shown in our study, UC patients have poorer results in respiratory function and a higher risk of OSAS compared to healthy individuals, and conditions such as severe disease and high mayo score in subgroups of UC patients also adversely affect these parameters. For all these reasons, assessment of pulmonary function and OSAS risk in UC patients should be a routine part of patient management.

References
1-Wangchuk P, Yeshi K, Loukas A. Ulcerative colitis: clinical biomarkers, therapeutic targets, and emerging treatments. Trends Pharmacol Sci. 2024;45(10):892-903. doi: 10.1016/j.tips.2024.08.003.
2-Kucharzik T, Koletzko S, Kannengiesser K, Dignass A. Ulcerative Colitis-Diagnostic and Therapeutic Algorithms. Dtsch Arztebl Int. 2020;117(33-34):564-574. doi: 10.3238/arztebl.2020.0564.
3-Hao G, Zhu B, Li Y, Wang P, Li L, Hou L.Sleep quality and disease activity in patients with inflammatory bowel disease: a systematic review and meta-analysis.Sleep Med. 2020;75:301-308. doi: 10.1016/j.sleep.2020.08.032.