P0618Lower visceral fat associates with active disease in men but not women with inflammatory bowel diseases

Abstract Background Visceral adipose tissue (VAT) is a metabolically active organ that modulates systemic and intestinal inflammation. While VAT expansion has been linked to metabolic dysfunction in inflammatory bowel disease (IBD), the influence of sex-specific adipose distribution remains largely unexplored. No studies to date have examined sex differences in VAT thickness in patients with IBD. This study aimed to characterize the relationship between VAT measured by ultrasound (US) and disease activity, stratified by sex. Methods We conducted a cross-sectional study of adults with IBD who underwent sonographic examination as part of routine assessment between January 2024 and August 2025. VAT thickness was measured from the linea alba to the anterior aortic wall. Demographics and clinical data were collected, along with clinical indices, biochemical markers and endoscopic findings. Composite disease activity was defined as active inflammation on ≥ 1 of the following within 3 months: IUS (bowel wall thickness 3 mm), endoscopic activity, CRP 8mg/L, fecal calprotectin 250mcg/g, or symptomatic activity. Continuous variables were analyzed using one-way ANOVA with Tukey’s post-hoc test for multiple comparisons when overall significance was achieved, and categorical variables were analyzed using the Freeman-Halton (extended Fisher’s exact) test. Analyses were stratified by sex to evaluate sex-specific associations between VAT and disease activity. Statistical significance was defined as p 0.05. Results A total of 124 patients with IBD were included (59% CD; 60% male; median age 43 years IQR 32–61). Median BMI was 25.2 kg/m² (IQR 22.4–29.1), with similar distribution between sexes (men: 25.8 23.1–29.4; women: 24.3 21.5-28.3). Median VAT thickness was higher in men (33.7 mm IQR 23.4-53.0 mm) than in women (28.6 mm IQR 13.7-49.4 mm). VAT correlated strongly with BMI in both sexes (men: Rho=0.66, p 0.0001; women: Rho = 0.58, p 0.0001). Among men, VAT thickness was significantly lower in those with active disease compared to those in remission (median 27.5 mm vs 44.0 mm; p = 0.0008 at 1 month; p = 0.0002 at 3 months). In women, VAT did not differ significantly between active and inactive disease (median 29.1 mm vs 27.8 mm; p = 0.67 at 1 month; p = 0.74 at 3 months). VAT was not associated with age at diagnosis, disease duration, HbA1c, lipid profile, metabolic disease, or corticosteroid exposure in either sex. Conclusion VAT thickness measured by US correlates with BMI in both men and women but shows a sex-specific relationship with inflammatory activity. VAT may reflect a disease-modifying metabolic phenotype in men and highlight the need for sex-specific reference ranges and prospective validation of VAT as a biomarker. Conflict of interest: Maracle, Brooke: No conflict of interest Hazra, Deepan: No conflict of interest Novak, Kerri L.: Research Grants: Helmsley Trust, Pfizer, Janssen Adboard, consulting fees: Abbvie, Janssen, Pfizer, Pendopharm, Takeda, Elli Lilly, Celltrion, Bristal Myers Non financial support (ultrasound machine) McKesson Pharmcy. Pfizer, Celltrion Lu, Cathy: Consultant for Pfizer, Abbvie, Eli Lilly and Pendopharm, and speaker for Takeda. Kaplan, Gilaad: Grant: Dr. Kaplan received grants for research from Ferring and for educational activities from AbbVie, Bristol Myers Squibb, Ferring, Fresenius-Kabi, Janssen, Pfizer, Takeda. Personal Fees: Dr. Kaplan has received honoraria for speaking or consultancy from AbbVie, Amgen, Janssen, Pfizer, and Takeda. Raman, Maitreyi: Abbvie Johnson & Johnson Celltrion LyfeMD Besney, Jonathan: No conflict of interest Reji, Rohita: No conflict of interest Aldarwish, Alia: No conflict of interest Seow, Cynthia: Advisory boards for Janssen, Abbvie, Takeda, Lilly, Ferring, Shire, Pfizer, Sandoz, Pharmascience, Fresenius Kabi, Amgen, Bristol Myers Squibb, and Celltrion and speaker for Janssen, Abbvie, Takeda, Lilly Ferring, Shire, Pfizer, Pharmascience, and Fresenius Kabi. Ingram, Richard James Michael: Consultancy fees: AbbVie, Amgen, CellTrion, Eli Lilly, J & J Innovative Medicine, Pfizer, Sanofi, Takeda Pharmaceuticals. Speakers’ honoraria: AbbVie, Amgen, BioJAMP, Eli Lilly, Pfizer, Takeda Pharmaceuticals. Stocks: AbbVie, Eli Lilly, Merck (discretionary managed). Ma, Christopher: Consulting fees: AbbVie, Alimentiv, Amgen, Anaptys Bio, AVIR Pharma Inc, Bristol Myers Squibb, Celltrion, Domain Therapeutics, Eupraxia, Eli Lilly, Ferring, Forte Biosciences, Fresenius Kabi, Gilead, Janssen, McKesson, Merck, Mirador Therapeutics, Pendopharm, Pfizer, Roche, Sanofi, Takeda, Tillotts Pharma Speaker’s fees: AbbVie, Amgen, AVIR Pharma Inc, Alimentiv, Bristol Myers Squibb, Eli Lilly, Ferring, Fresenius Kabi, Janssen, Merck, Organon, Pendopharm, Pfizer, Sanofi, Takeda, Tillotts Pharma Royalties: Springer Publishing Research Support: AbbVie, Eli Lilly, Ferring, Pfizer Panaccione, Remo: Grant: Abbvie, Janssen, Pfizer, Takeda Other: Consultant for: Abbott, AbbVie, Abbivax, Alimentiv (formerly Robarts), Amgen, AnaptysBio, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JBio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pendopharm, Pfizer, Progenity, Prometheus Biosciences, Protagonist Therapeutics, Roche, Sandoz, Satisfai Health, Shire, Sublimity Therapeutics, Spyre Therapeutics, Takeda Pharmaceuticals, Theravance Biopharma, Trellus, Union Biopharma, Viatris, Ventyx, UCB Speaker’s Fees for: AbbVie, Amgen, Arena Pharmaceuticals, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Gilead Sciences, Janssen, Merck, Organon, Pfizer, Roche, Sandoz, Shire, Takeda Pharmaceuticals Advisory Boards for: AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JBio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Roche, SandozShire, Sublimity Therapeutics, Takeda Pharmaceuticals, Ventyx. Dr. St-Pierre, Joelle: Consultant for Pfizer, Abbvie, Eli Lilly and Pendopharm, and speaker for Takeda.