Association between Mucosal Healing and Lipid Profiles in Patients with Ulcerative Colitis: A Cross-Sectional Study

Abstract

<b><i>Introduction:</i></b> Recent meta-analysis showed that ulcerative colitis (UC) is a risk factor for cardiovascular disease (CVD). Dyslipidemia is a well-established risk factor for CVD. However, evidence regarding inflammatory bowel disease (IBD), including UC and lipid profiles, is limited. Additionally, no study has assessed the association between endoscopic activity and lipid profiles in patients with IBD. Therefore, we aimed to clarify the association between mucosal healing (MH) and lipid profiles in patients with UC. <b><i>Methods:</i></b> A total of 221 Japanese patients with UC were enrolled in this analysis. Total cholesterol (T-chol), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) were divided into tertiles (high, moderate, and low) based on the distributions, respectively. Self-administered questionnaire was used to obtain information regarding medication for dyslipidemia. Complete MH and MH are based on Mayo endoscopic subscore 0 and 0–1, respectively. <b><i>Results:</i></b> The percentage of complete MH was 30.8%. In patients without medication for dyslipidemia, high HDL-C (>66 mg/dL) was significantly positively associated with complete MH (adjusted odds ratio [OR] 2.58, 95% CI: 1.04–6.64, <i>p</i> for trend = 0.037). In patients with nonproctitis, a positive association between HDL-C and complete MH was found (adjusted OR 3.54, 95% CI: 1.22–11.01, <i>p</i> for trend = 0.020). T-chol and TG were not associated with MH, regardless of medication for dyslipidemia. <b><i>Conclusions:</i></b> Complete MH was significantly positively associated with HDL-C in UC patients without medication for lipid. The disease extent might affect the association between complete MH and HDL-C.

To explore the causal association between the serum lipid profile and inflammatory bowel disease using bidirectional Mendelian randomisation analysis

“…35 High HDL-C levels are positively correlated with complete mucosal healing. 36 Although these cross-sectional studies suggest a potential link between IBD and serum lipid profiles, they do not imply causation. Current MR research on IBD and serum lipids is scarce, [14][15][16] with results suggesting a causal relationship between elevated LDL-C and HDL-C levels and a reduced risk of IBD (including UC and CD), 14 15 while findings on the causal relationship between TC and UC are contradictory.…”