P1154 - Temporal Patterns of Body Mass Index, Health Care Resource Utilization, and Biomarkers in Patients With Ulcerative Colitis; A Descriptive Study of Electronic Health Records

Stephen Shields, MPH¹, Ruthvik Padival, MD², Russel Burge, PhD, MA³, Ann Von Holle, PhD⁴, Jeff T. Mohl, PhD⁵, Jianmin Wu, ³, Richard E.. Moses, DO, JD³, Ginger S.. Haynes, PhD³, Elizabeth L.. Ciemins, PhD, MPH, MA¹
1AMGA (American Medical Group Association), Alexandria, VA; 2Intermountain Health, Salt Lake City, UT; 3Eli Lilly and Company, Indianapolis, IN; 4American Medical Group Association, Chapel Hill, NC; 5AMGA, Alexandria, VA

Introduction: Obesity contributes to increased healthcare resource utilization (HCRU), primarily due to its association with chronic conditions such as cardiovascular disease and diabetes. However, obesity’s impact on HCRU among patients with inflammatory bowel disease is not well understood. Specifically, recent comprehensive data on HCRU among ulcerative colitis (UC) patients remain limited. We aimed to describe demographics, relevant biomarkers, and HCRU stratified by body mass index (BMI) over time in a large United States (US)- based cohort study.

Methods: This was a retrospective database cohort study on UC patients. Index date was the first qualifying physician visit in 2019. Data were derived from the Optum Labs Data Warehouse, a de-identified, national, longitudinal, real-world data asset with anonymized clinical Electronic Health Records from >50 health care organizations across the US. Baseline demographics, inflammatory biomarkers, HCRU, treatments, and comorbidities were analyzed descriptively, both overall and stratified by BMI categories (Normal, Overweight, Obesity Classes 1-3). HCRU measures--emergency room (ER) visits per 100 patient-years, inpatient (IP) stays per 100 patient-years, outpatient visits (OP) per year, and office visits (OV) per year-- were described at 1-, 3-, and 5-years post-index, overall and by BMI group.

Results: At baseline, median inflammatory marker levels for C-Reactive Protein (CRP), High-Sensitivity C-Reactive Protein (HS-CRP), and Erythrocyte Sedimentation Rate (ESR) were higher for patients in higher BMI groups (p < 0.001) (Table 1). Median calprotectin levels were not substantively different across BMI categories. HCRU metrics (ER visits, IP stays, OP visits and OV) tended to be higher on average by higher BMI group, especially for BMI 35-39.9 group versus the BMI 18.5-24.9 group. HCRU also tended to increase over time within BMI categories (Table 2).

Discussion: These findings suggest that among patients with UC, those with elevated BMI (overweight or obese) have higher overall HCRU versus patients with normal BMI. The growing use of GLP-1 receptor agonists has spurred interest in understanding how obesity and overweight affect HCRU. Obesity management could be an important strategy for decreasing HCRU, benefiting both UC patients and providers. Future studies using this sample will estimate associations between BMI and HCRU, costs, and lab values, over time for UC-related and obesity-related complications.


Figure: Table 1: Baseline characteristics of patients with UC


Figure: Table 2: All-Cause HCRU over time in patients with UC

Disclosures:
Stephen Shields: Eli Lilly & Company – Grant/Research Support.
Ruthvik Padival indicated no relevant financial relationships.
Russel Burge: Eli Lilly and Company – Employee, Stock-publicly held company(excluding mutual/index funds).
Ann Von Holle indicated no relevant financial relationships.
Jeff Mohl indicated no relevant financial relationships.
Jianmin Wu: Eli Lilly and Company – Employee, Stock Options.
Richard Moses: Eli Lilly and Company – Employee, Stock Options.
Ginger Haynes: Eli Lilly and Company – Employee, Stock-publicly held company(excluding mutual/index funds).
Elizabeth Ciemins indicated no relevant financial relationships.

Stephen Shields, MPH¹, Ruthvik Padival, MD², Russel Burge, PhD, MA³, Ann Von Holle, PhD⁴, Jeff T. Mohl, PhD⁵, Jianmin Wu, ³, Richard E.. Moses, DO, JD³, Ginger S.. Haynes, PhD³, Elizabeth L.. Ciemins, PhD, MPH, MA¹. P1154 - Temporal Patterns of Body Mass Index, Health Care Resource Utilization, and Biomarkers in Patients With Ulcerative Colitis; A Descriptive Study of Electronic Health Records, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.