P756 Comorbidities in adolescents with inflammatory bowel disease: Findings from a population-based cohort

Abstract

Objectives and Study: Inflammatory bowel diseases (IBD) are systemic inflammatory conditions associated with various autoimmune disorders and higher prevalence of other diagnoses and complications. We aimed to investigate the association of IBD with various medical conditions at late adolescence in a large cross-sectional population based study. Method(s): A total of 1,142,732 Jewish Israeli adolescents who underwent a general health examination at a median age of 17.1 years from 2002 to 2016 were included. A definite diagnosis of IBD was based on accepted criteria. Cases were further classified into Crohn's disease (CD) and ulcerative colitis (UC). Covariate data included demographic measures, and data on associated medical conditions. Result(s): Overall, data for 891 subjects with IBD (595 with CD, 296 with UC) and 1,141,841 controls were available. Multivariate analyses showed that autoimmune diseases were significantly more common in subjects with CD, including primary sclerosing cholangitis (PSC), odds ratio (OR 354), autoimmune hepatitis (OR 4), arthritis (OR 3), thyroid diseases, and uveitis (OR 4.7). Positive correlation in multivariate analysis was observed in UC for PSC (OR 1131), autoimmune hepatitis (OR 3.4), arthritis (OR 2.4) and immune thrombocytopenic purpura (OR 5.9), p< 0.001 for all positive associations. Asthma, allergic rhinitis, allergic conjunctivitis, atopic dermatitis, chronic urticaria, vasculitis, thyroid diseases,and vitiligo were not associated with either CD or UC. Non-autoimmune associations for CD included urolithiasis (OR 3.6), pancreatitis (OR 21.5), and renal diseases (OR 2.7), p< 0.001 for all. UC was associated with pancreatitis (OR 26.1), and urinary abnormalities (OR 3.2), p< 0.001 for all. Interestingly, fractures of long bones were negatively associated with both CD (OR 0.51) and UC (OR 0.67). Axial fractures and migrane were not more common in both CD and UC. All positive assiciations were more prevalent in male patients with either CD or UC. Celiac disease was only associated with diagnosis of CD in males (OR 3.7). Conclusion(s): Already at adolescence, both CD and UC are associated with multiple comorbidities, not limited to autoimmune disorders. There is a male preponderance for most comorbidities.