Background: The cardioprotective diet was reported to be associated with several chronic cardiometabolic diseases through an anti-inflammation effect. However, the association between the cardioprotective diet and the risk of inflammatory bowel disease (IBD) was unclear and deserved to be further explored. Methods: We calculated the cardioprotective diet score based on the consumptions of seven common food groups using the validated food frequency questionnaire data in the UK Biobank. Incident IBD was ascertained from primary care data, inpatient data, and the death registry. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between the cardioprotective diet score and the risk of IBD. Results: During a mean follow-up of 12.1 years, we documented 2717 incident IBD cases, including 851 cases of Crohn’s disease and 1866 cases of ulcerative colitis. Compared to participants with a cardioprotective diet score of 0–1, we observed a decreased risk of IBD among participants with cardioprotective diet scores of 3 (HR 0.85, 95% CI 0.73–0.99), 4 (HR 0.84, 95% CI 0.72–0.98), and 5–7 (HR 0.77, 95% CI 0.66–0.89) (p-trend < 0.001). Conclusions: A greater adherence to the cardioprotective diet was associated with a lower risk of IBD. Our finding highlighted the importance of focusing on the cardioprotective diet to prevent IBD.

Background: Although the beneficial properties of vitamin D in anti-inflammation and immunity-modulation are promising in the management of inflammatory bowel disease (IBD), data were limited for the critical IBD prognosis. The association between serum vitamin D levels and the risk of bowel resection in individuals with IBD remains largely unknown. Materials and Methods: The authors performed a longitudinal cohort study among 5474 individuals with IBD in the UK Biobank. Serum 25-hydroxyvitamin D [25(OH)D] was measured using direct competitive chemiluminescent immunoassay. Bowel resection events were ascertained via national inpatient data. Multivariable-adjusted Cox proportional hazard regression was used to examine the association between serum 25(OH)D and bowel resection risk, presented with hazard ratios (HRs) and 95% CIs. Restricted cubic spline (RCS) was used to evaluate dose-response associations. Results: During a mean follow-up of 13.1 years, the authors documented 513 incident bowel resection cases. Compared to participants with vitamin D deficiency, nondeficient participants showed a significantly reduced bowel resection risk in IBD (HR 0.72, 95% CI: 0.59–0.87, P=0.001), Crohn’s disease (CD, HR 0.74, 95% CI: 0.56–0.98, P=0.038), and ulcerative colitis (UC, HR 0.73, 95% CI: 0.57–0.95, P=0.020). When comparing extreme quintiles of 25(OH)D level, participants with IBD showed a 34% reduced risk of bowel resection (95% CI: 11–51%, P=0.007) and participants with UC showed a 46% reduced risk (95% CI: 19–64%, P=0.003), while this association was not significant in CD (HR 0.93, 95% CI: 0.59–1.45, P=0.740). Linear dose-response associations were observed using the RCS curve (all P-nonlinearity>0.05). Conclusion: Increased serum level of 25(OH)D is independently associated with reduced bowel resection risk in IBD. This association was significant in UC but may not be stable in CD. Vitamin D deficiency is a risk factor for bowel resection in individuals with IBD, and may be an effective metric in predicting and risk-screening surgical events.

Background: The association of vitamin D deficiency, which is prevalent in type 2 diabetes mellitus (T2DM), with liver disease and related mortality has not been quantified. Our study aimed to (1) investigate whether there is a synergistic association of vitamin D deficiency and T2DM with liver-related outcomes and (2) explore whether high 25-hydroxyvitamin D [25(OH)D] concentrations are associated with a lower risk of liver-related outcomes in T2DM. Method: Leveraging the data from UK Biobank, we conducted 2 studies: study I assessed the joint associations of vitamin D deficiency [25(OH)D <50 nmol/L] and T2DM with liver-related outcomes among 439,276 participants, and study II explored the associations of vitamin D status with liver-related outcomes among 21,519 individuals with T2DM. Baseline T2DM was identified through medication, laboratory test, and electronic health-related records. Serum 25(OH)D was measured by direct competitive chemiluminescent immunoassay. Liver-related outcomes included 6 liver disease end points and mortality by overall liver disease, chronic liver disease, and severe liver disease. Results: During an average follow-up duration of 11.6 years, we observed a significant positive additive interaction effect (all synergy index>1.0) of T2DM and vitamin D deficiency on the risk of liver-related outcomes. Compared with participants without either T2DM or vitamin D deficiency, the multivariable-adjusted HRs of overall liver diseases were 1.29 for participants without T2DM but with vitamin D deficiency, 1.73 for participants with T2DM but without vitamin D deficiency, and 2.19 for participants with both T2DM and vitamin D deficiency. In individuals with T2DM, we observed that participants without vitamin D deficiency were inversely associated with incident liver disease and related mortality (multivariable-adjusted HRs 0.41–0.81) when compared with individuals with vitamin D deficiency. Conclusions: There are positive synergistic associations of vitamin D deficiency and T2DM with liver-related outcomes. Inverse associations between serum 25(OH)D concentrations and liver-related outcomes were observed in individuals with T2DM. Export

Background: Previous studies indicated discrete lifestyle health metrics that benefit cardiovascular health are associated with better prognosis in inflammatory bowel disease (IBD), while evidence regarding the comprehensive impact of cardiovascular health remains limited. This study aimed to investigate the association between the overall cardiovascular health indicator, Life’s Essential 8 (LE8), and the adverse outcomes of IBD. Materials and methods: We included 3232 IBD participants recruited from the UK Biobank between 2006 and 2010. LE8 encompasses 8 metrics, including physical activity, diet, sleep health, nicotine exposure, body mass index, blood glucose, blood lipids, and blood pressure. The adverse outcomes studied in our study included IBD-related surgery and all-cause mortality. Hazard ratios (HRs) with 95% confidence intervals (CIs) for the strength of the associations between LE8 score and IBD-related surgery as well as all-cause mortality were calculated using Cox proportional hazard models. Results: Over a mean (standard deviation) follow-up of 12.60 (2.74) years and 13.17 (1.89) years, 282 IBD-related surgery and 259 death events were recorded. Ulcerative colitis (UC) patients with a high LE8 score showed decreased risk of IBD-related surgery (HR 0.47, 95% CI 0.26, 0.87) and all-cause mortality (HR 0.47, 95% CI 0.25, 0.87), in comparison to those with a low LE8 score. No significant associations were observed between LE8 score and the risk of IBD-related surgery and all-cause mortality among Crohn’s disease (CD) in the primary analyses. Conclusion: Participants with a higher LE8 score showed decreased risk of IBD-related surgery and all-cause mortality among UC, but not CD, underscoring the significance of implementing LE8 as a management approach in improving the prognosis of UC.