Metabolic Drivers of Disease Activity and Complications in Crohn’s Disease: A Retrospective Cross-Sectional Study
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
This study aims to examine the independent relationships between individual components of metabolic syndrome (MetS) and two key clinical outcomes in patients with Crohn’s disease (CD): disease activity, as quantified by the Crohn’s Disease Activity Index (CDAI), and the occurrence of complications.
Methods
This retrospective cross-sectional study included 376 adults with newly diagnosed Crohn’s disease. Multiple linear regression was used to examine associations between metabolic parameters and CDAI scores, while multivariate logistic regression assessed links to complications. Analyses were also based on clinical CDAI cut-offs. Predictive nomograms were developed and internally validated via bootstrap resampling.
Results
Multiple linear regression indicated that higher CDAI scores were independently associated with lower BMI (B = −5.866, P < 0.001), lower HDL-C levels (B = −81.770, P < 0.001), higher triglycerides (B = 15.618, P = 0.001), and lower ESR (B = −0.375, P = 0.03). Multivariate logistic regression established low HDL-C (OR = 0.042, P < 0.001), low BMI (OR = 0.915, P = 0.034), and high triglycerides (OR = 1.792, P = 0.007) as significant independent risk factors for complications. The developed nomograms demonstrated strong predictive performance, with an adjusted R 2 of 0.207 for the CDAI model and an AUC of 0.765 for the complication model. For both predictive tasks, the model incorporating separate TG and HDL-C measurements significantly outperformed the TG/HDL-C ratio model.
Conclusion
Metabolic disturbances demonstrate a significant association with increased disease severity and a higher risk of complication development in Crohn’s disease.
Core tip
Dual-outcome study reveals HDL-C and TG differentially link to CD inflammation and complications, pointing to distinct mechanisms.
Low HDL-C is the strongest independent predictor for CD complications, underscoring its protective role beyond cholesterol transport.
Individual TG and HDL-C metrics outperform their ratio in prediction, challenging its use and suggesting independent pathways in CD.
Low BMI independently associates with both adverse outcomes, refining the “obesity paradox” and highlighting malnutrition’s key role.
A practical, validated nomogram (AUC=0.765) integrates HDL-C, TG, and BMI to stratify complication risk, aiding clinical decision-making.
