{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:29:45Z","timestamp":1768570185653,"version":"3.49.0"},"posted":{"date-parts":[[2025,6,2]]},"group-title":"Gastroenterology","reference-count":27,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Inflammatory bowel disease (IBD) manifests systemically, yet most comorbidity studies rely on predominantly European populations. The All of Us Research Program enables investigation across demographically diverse groups.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We matched 5,094 IBD patients 1:4 with controls by age, gender, and race, analyzing comorbidities using logistic regression with Mantel-Haenszel adjustment. Multiple testing correction used false discovery rate (FDR) with significance thresholds of OR &gt;1.5 or &lt;0.5 and FDR &lt;0.05.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our cohort included 29.2% non-White participants versus 10-15% in traditional studies. We identified 22 significant associations across seven organ systems. Three novel discoveries included delayed postmyocardial infarction pericarditis (adjusted OR = 4.80), contact dermatitis (adjusted OR = 1.84), and carotid artery aneurysm (adjusted OR = 2.21). Other significant associations included drug-induced lupus (adjusted OR = 4.32), autoimmune hepatitis (adjusted OR = 2.43), and restricting-type eating disorders (adjusted OR = 4.00). IBD patients showed decreased obesity-related conditions.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This demographically diverse study discovered novel IBD comorbidities and confirmed established associations across racial groups. Findings support reconceptualizing IBD as a multisystem disorder requiring comprehensive management and demonstrate the importance of diverse research populations.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.06.01.25328740","type":"posted-content","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T14:25:17Z","timestamp":1748874317000},"source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Bowel: Novel Comorbidity Patterns in Inflammatory Bowel Disease from the All of Us Research Program"],"prefix":"10.64898","author":[{"given":"Soham C.","family":"Sudhakaran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-858X","authenticated-orcid":false,"given":"Matthew T.","family":"Wayland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yogesh","family":"Purushothaman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott B.","family":"Minchenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanwal","family":"Bains","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6527-1085","authenticated-orcid":false,"given":"Sudhakaran","family":"Prabakaran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"issue":"13","key":"2025060408201338000_2025.06.01.25328740v1.1","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/S0735-1097(24)02731-1","article-title":"Predictors and Outcomes of Acute Pericarditis in Inflammatory Bowel Disease: A Nationwide Analysis","volume":"83","year":"2024","journal-title":"Journal of the American College of Cardiology"},{"key":"2025060408201338000_2025.06.01.25328740v1.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1809937"},{"issue":"February","key":"2025060408201338000_2025.06.01.25328740v1.3","first-page":"1756284819827692","article-title":"Incidence of Inflammatory Bowel Disease by Race and Ethnicity in a Population-Based Inception Cohort from 1970 through 2010","volume":"12","year":"2019","journal-title":"Therapeutic Advances in Gastroenterology"},{"issue":"8","key":"2025060408201338000_2025.06.01.25328740v1.4","first-page":"643","article-title":"Comorbidities in Inflammatory Bowel Disease: A Call for Action.\u201d The Lancet","volume":"4","year":"2019","journal-title":"Gastroenterology & Hepatology"},{"issue":"6","key":"2025060408201338000_2025.06.01.25328740v1.5","first-page":"622","article-title":"\u201cPrevalence, Comorbidity, and Sociodemographic Correlates of Psychiatric Disorders Reported in the All of Us Research Program.\u201d JAMA Psychiatry (Chicago","volume":"79","year":"2022","journal-title":"Ill"},{"issue":"9-S","key":"2025060408201338000_2025.06.01.25328740v1.6","first-page":"76","article-title":"Renal Lithiasis and Inflammatory Bowel Diseases, an Update on Pediatric Population","volume":"89","year":"2018","journal-title":"Acta Bio-Medica : Atenei Parmensis"},{"issue":"6","key":"2025060408201338000_2025.06.01.25328740v1.7","doi-asserted-by":"crossref","first-page":"e0305220","DOI":"10.1371\/journal.pone.0305220","article-title":"Inflammatory Bowel Disease and Risk of Autoimmune Hepatitis: A Univariable and Multivariable Mendelian Randomization Study","volume":"19","year":"2024","journal-title":"PloS One"},{"issue":"3","key":"2025060408201338000_2025.06.01.25328740v1.8","first-page":"otab023","article-title":"Methodology and Initial Results from a Real-World Observational Cohort of Patients with Inflammatory Bowel Disease: TARGET-IBD","volume":"360","year":"2021","journal-title":"Crohn\u2019s & Colitis"},{"issue":"12","key":"2025060408201338000_2025.06.01.25328740v1.9","first-page":"1417","article-title":"\u201cAssociation of Psoriasis with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.\u201d JAMA Dermatology (Chicago","volume":"154","year":"2018","journal-title":"Ill"},{"issue":"7","key":"2025060408201338000_2025.06.01.25328740v1.10","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1038\/s41390-019-0702-3","article-title":"Comorbidities in Adolescents with Inflammatory Bowel Disease: Findings from a Population-Based Cohort Study","volume":"87","year":"2020","journal-title":"Pediatric Research"},{"key":"2025060408201338000_2025.06.01.25328740v1.11","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.81"},{"key":"2025060408201338000_2025.06.01.25328740v1.12","unstructured":"Hracs, Lindsay , Joseph W. 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Buie , Joshua Quan , et al. 2025. \u201cGlobal Evolution of Inflammatory Bowel Disease across Epidemiologic Stages.\u201d Nature , April, 1\u20139."},{"key":"2025060408201338000_2025.06.01.25328740v1.13","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.07.065"},{"issue":"1","key":"2025060408201338000_2025.06.01.25328740v1.14","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s41927-020-0115-2","article-title":"Healthcare Resource Utilization and Costs Associated with Inflammatory Bowel Disease among Patients with Chronic Inflammatory Diseases: A Retrospective Cohort Study","volume":"4","year":"2020","journal-title":"BMC Rheumatology"},{"issue":"4","key":"2025060408201338000_2025.06.01.25328740v1.15","first-page":"719","article-title":"Statistical Aspects of the Analysis of Data from Retrospective Studies of Disease","volume":"22","year":"1959","journal-title":"Journal of the National Cancer Institute"},{"issue":"3","key":"2025060408201338000_2025.06.01.25328740v1.16","first-page":"330","article-title":"\u201cIncidence of Psoriasis in Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Matched Cohort Study.\u201d Dermatology (Basel","volume":"237","year":"2021","journal-title":"Switzerland"},{"issue":"2","key":"2025060408201338000_2025.06.01.25328740v1.17","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1093\/ije\/dyy298","article-title":"Cohort Profile Update: The Swiss Inflammatory Bowel Disease Cohort Study (SIBDCS)","volume":"48","year":"2019","journal-title":"International Journal of Epidemiology"},{"issue":"4","key":"2025060408201338000_2025.06.01.25328740v1.18","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1080\/08037051.2018.1476055","article-title":"Increased Arterial Stiffness \u2013 Similar Findings in Patients with Inflammatory Bowel Disease without Prior Hypertension or Diabetes and in Patients with Well-Controlled Hypertension","volume":"27","year":"2018","journal-title":"Blood Pressure"},{"key":"2025060408201338000_2025.06.01.25328740v1.19","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izab071"},{"issue":"8","key":"2025060408201338000_2025.06.01.25328740v1.20","first-page":"100570","article-title":"\u201cThe All of Us Research Program: Data Quality, Utility, and Diversity.\u201d Patterns (New York","volume":"3","year":"2022","journal-title":"N.Y"},{"issue":"3","key":"2025060408201338000_2025.06.01.25328740v1.21","first-page":"quiz e22","article-title":"Risk of Cerebrovascular Accidents and Ischemic Heart Disease in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","volume":"12","year":"2014","journal-title":"Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association"},{"key":"2025060408201338000_2025.06.01.25328740v1.22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016695"},{"key":"2025060408201338000_2025.06.01.25328740v1.23","doi-asserted-by":"crossref","unstructured":"Ticinesi, Andrea , Antonio Nouvenne , and Tiziana Meschi . 2019. \u201cGut Microbiome and Kidney Stone Disease: Not Just an Oxalobacter Story.\u201d Kidney International. 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