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. 2025 Nov-Dec;38(6):618-628.
doi: 10.20524/aog.2025.1011. Epub 2025 Oct 10.

Epidemiology of metabolic syndrome in patients with inflammatory bowel disease: a population-level cohort study from the United States

Aakash Desai  1 , Himsikhar Khataniar  2 , Jana G Hashash  3 , Priya Sehgal  4 , Francis A Farraye  3 , Gursimran S Kochhar  1
Affiliations

Epidemiology of metabolic syndrome in patients with inflammatory bowel disease: a population-level cohort study from the United States

Aakash Desai et al. Ann Gastroenterol. 2025 Nov-Dec.

Abstract

Background: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

Methods: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

Results: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply with age (12-14% at 18-39 to 47-50% at ≥65) and was higher in men than women. Rates were greatest among American Indian (CD 45.2%), Black (40%) and Hispanic (38-39%) populations, and lowest in Asian patients (26%). MetS clustered with more severe phenotypes (stricturing CD, prior CD surgery) and was not elevated among patients receiving advanced therapy. MetS was associated with greater systemic corticosteroid use and higher surgery/colectomy risk, while stricture and fistula risks in CD were similar; advanced therapy was not initiated more frequently in CD.

Conclusion: Our study provides updated epidemiological estimates of MetS in patients with IBD in the US.

Keywords: Crohn’s disease; Inflammatory bowel disease; epidemiology; metabolic syndrome; ulcerative colitis.

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Conflict of interest statement

Conflict of Interest: AD, HK and PS: None exist. JH: Advisory Board BMS. FAF: Consultant for AbbVie, BMS, Braintree Labs, Fresenius Kabi, GSK, IBD Educational Group, Iterative Health, Janssen, Pharmacocosmos, Pfizer and Sebela. He previously served on a DSMB for Lilly. GSK: Advisory board – CoreVetas Research, Eli Lilly, GIE Medical; Consultant – Boston Scientific Endoscopy, Olympus Endoscopy, Pentax Endoscopy; Speaker – Eli Lilly; Stock options – DigBi Health

Figures

Figure 1
Figure 1
Incidence proportion (A, C) and prevalence (B, D) of each component of metabolic syndrome in patients with ulcerative colitis (1) and Crohn’s disease (2) from 2010-2023
See this image and copyright information in PMC

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