Cardiometabolic diseases in patients with inflammatory bowel disease: An evidence-based review

Abstract

Metabolic syndrome-comprising central adiposity, dyslipidaemia, insulin resistance, and hypertension-is a major risk factor for cardiometabolic diseases such as ischaemic heart disease, stroke, and type 2 diabetes. Its global prevalence is rising, largely driven by urbanization, sedentary lifestyles, and dietary changes. These same factors are also associated with the increasing incidence of inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis. Emerging evidence supports a potential biological link between chronic gastrointestinal inflammation and the later development of cardiometabolic disorders; a connection that is particularly relevant for patients with IBD. Comparative studies examining cardiometabolic risk associated with Crohn's disease versus ulcerative colitis have reported inconsistent findings, likely due to confounding factors such as age, lifestyle, and comorbidities. This review summarizes current evidence linking IBD and cardiometabolic disorders, and highlights the need for clinicians to recognize cardiometabolic risk in patients with IBD. Future research should investigate whether treat-to-target strategies focused on controlling intestinal inflammation can simultaneously improve both long-term IBD and cardiometabolic outcomes.

Keywords: Cardiometabolic diseases; Cardiovascular disease; Crohn’s disease; Gastrointestinal inflammation; Inflammatory bowel disease; Metabolic liver disease; Metabolic syndrome; Obesity; Stroke; Ulcerative colitis.

Figure 1

Evidence-based associations between cardiometabolic disorders and inflammatory bowel disease. Positive association (+), negative associations (-) unknown association (?)[196-198].