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Causal relationship between inflammatory bowel disease and cardiovascular disease: a two-sample Mendelian randomized
Lianghao Ma1, Lishan Ding2, Zuoying Xing1
1Department of Cardiovascular Diseases, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, China.
Archives of Medical Science : AMS
|December 17, 2025
Summary
Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is linked to a higher risk of chronic heart failure. However, IBD does not appear to causally increase the risk for other cardiovascular diseases.
Area of Science:
- Genetics
- Gastroenterology
- Cardiology
Background:
- Epidemiological studies suggest a link between inflammatory bowel disease (IBD) and cardiovascular diseases (CVDs).
- The precise causal relationship between IBD and various CVDs remains unclear, necessitating further investigation.
- IBD encompasses Crohn's disease (CD) and ulcerative colitis (UC).
Purpose of the Study:
- To investigate the potential causal effect of IBD (CD and UC) on the risk of developing specific CVDs.
- To differentiate the causal associations between IBD subtypes and distinct cardiovascular outcomes.
Main Methods:
- Two-sample Mendelian randomization (MR) analysis was employed.
- Genetic variants (SNPs) associated with CD and UC served as instrumental variables.
- Inverse variance weighted (IVW), MR-Egger, and weighted median methods were utilized to assess causality.
- Sensitivity analyses, including Cochrane's Q test and leave-one-out analysis, were performed to ensure result robustness.
Main Results:
- A statistically significant positive correlation was found between Crohn's disease and an increased risk of chronic heart failure (OR = 1.02; 95% CI: 1.00-1.04).
- Similarly, ulcerative colitis showed a positive correlation with an increased risk of chronic heart failure (OR = 1.03; 95% CI: 1.00-1.06).
- No significant causal associations were detected between CD or UC and the risk of atrial fibrillation, coronary heart disease, myocardial infarction, or hypertension.
Conclusions:
- Crohn's disease and ulcerative colitis are causally associated with an elevated risk of chronic heart failure.
- The study found no evidence of a causal link between IBD and other major cardiovascular diseases such as atrial fibrillation, coronary heart disease, myocardial infarction, and hypertension.
- These findings highlight a specific cardiovascular risk associated with IBD, particularly chronic heart failure.
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