What question did this study set out to answer?

This research aimed to examine the relationship between fat mass and extraintestinal joint manifestations in Crohn's Disease.

January 23, 2026

P0323Fat Mass as a Determinant of Extraintestinal Joint Manifestations in Crohn’s Disease: Evidence from a Body Composition-Based Stratification Analysis

Key Points

This research aimed to examine the relationship between fat mass and extraintestinal joint manifestations in Crohn's Disease.
Conducted a cross-sectional study with patients diagnosed with Crohn's Disease and Ulcerative Colitis.
Assessed body composition using bioelectrical impedance analysis and stratified patients by fat mass tertiles.
Analyzed associations using chi-squared tests, one-way ANOVA, and multivariate logistic regression.
No significant differences in clinical characteristics observed across fat mass tertiles for both patient groups.
In Crohn's Disease patients, higher fat mass correlated with a greater frequency of severe disease according to the Harvey–Bradshaw Index.
63% of patients with higher fat mass exhibited extraintestinal joint manifestations, compared to 48% and 29% in mid and lower tertiles, respectively.

Abstract

Abstract Background Extraintestinal manifestations, particularly joint involvement, affect approximately 20–45% of patients with inflammatory bowel disease (IBD) and contribute substantially to overall disease burden1. Given the emerging role of body composition in modulating systemic inflammation2-3, this study investigated the association between Fat Mass (FM)% and extraintestinal joint manifestations (EJM). Methods A cross-sectional study included 81 Crohn’s Disease (CD, M/F=38/43; age 43±17 years; disease duration 12±11years); and 157 Ulcerative Colitis (UC; M/F=63/94; age 48±14 years; disease duration 14±10 years) patients who were evaluated at a tertiary referral center (March 2024-June 2025). All participants underwent body composition assessment and stratified by FM tertiles using bioelectrical impedance analysis (BIA). Chi-square, one-way ANOVA, and multivariate logistic regression analyses were used. Results Across FM% levels (tertiles) no significant differences emerged in clinical characteristics such as disease duration, extent, or phenotype neither in CD or UC patients (Table I and II). In CD but not in UC, FM% was associated with more frequent severe disease according to the Harvey–Bradshaw Index (p=0.001) (Table I). Forty-seven per cent (n = 38) CD and 39% (n = 61) UC patients had EJM. In particular, CD patients with the higher FM% exhibited a greater frequency of EJM (63%) compared to those in the mid (48%) and in the lowest range (29%) (Table I and Figure 1A). These findings were confirmed by the multivariate logistic regression model adjusted for disease duration and disease activity (OR 1.06, 95% CI 0.99-1.12; p=0.008). Conclusion In CD patients, higher FM% was associated with an increased prevalence of EJM. These findings suggest a possible link between excess adiposity and musculoskeletal involvement and a role for the body composition as a potential modifier of the extraintestinal disease burden. References: 1. Khrom, M., Long, M., & Dube, S., et al. (2024). Comprehensive association analyses of extraintestinal manifestations in inflammatory bowel disease. Gastroenterology, 167(2), 315–332. doi.org/10.1053/j.gastro.2024.02.026 2. Ratajczak-Pawłowska, A. E., Michalak, M., & Szymczak-Tomczak, A., et al. (2025). Is there any association between fat body mass and bone mineral density in patients with Crohn’s disease and ulcerative colitis? Nutrients,17(3), 466. doi.org/10.3390/nu17030466 3. Yarur, A. J., Bruss, A., & Moosreiner, A., et al. (2023). Higher intra-abdominal visceral adipose tissue mass is associated with lower rates of clinical and endoscopic remission in patients with inflammatory bowel diseases initiating biologic therapy: Results of the Constellation Study. Gastroenterology, 165(4), 963–975.e5. https://doi.org/10.1053/j.gastro.2023.06.036 Conflict of interest: Prof. Spagnuolo, Rocco: no Morano, Domenico: No conflict of interest Scarlata, Giuseppe Guido Maria: No conflict of interest Giudice, Anna: No conflict of interest Ferro, Yvelise: No conflict of interest Marafioti, Giuseppe: No conflict of interest Carrabetta, Federico: No conflict of interest Elisa, Mazza: No conflict of interest Suraci, Evelina: No conflict of interest Marasco, Raffaella: No conflict of interest Imeneo, Maria: No conflict of interest Noto, Francesca Rita: No conflict of interest Montalcini, Tiziana: No conflict of interest Abenavoli, Ludovico: No conflict of interest Pujia, Arturo: No conflict of interest Luzza, Francesco: No conflict of interest

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