Abstract
PURPOSE: Visceral adipose tissue (VAT) is integral to the pathology of Crohn's disease (CD). While trace element imbalances affect both adipose tissue function and CD progression, their interplay remains poorly characterized. This study aimed to examine whether trace element status affects CD outcomes and whether this relationship is moderated by visceral adiposity. PATIENTS AND METHODS: The data were collected retrospectively based on a prospective cohort of 300 patients newly diagnosed with CD from July 2019 to June 2022. Baseline plasma trace element levels were assessed, and VAT was measured via computed tomography (CT) scans at the time of diagnosis. Logistic regression analyses were performed. RESULTS: Lower zinc and magnesium levels predicted clinical outcomes including intestinal complications and surgery (OR = 0.51, P = 0.002; OR = 0.52, P = 0.001), and poorer treatment response (OR = 0.39, P < 0.001; OR = 0.57, P = 0.004). Elevated copper levels were associated with clinical outcomes (OR = 1.68, P = 0.012). Notably, stratified analysis revealed that magnesium's protective effect was significant exclusively in patients with visceral-to-subcutaneous adipose tissue ratio (VAT/SAT) ≥ 1, whereas the effect of copper was significant solely in the VAT/SAT < 1 group concerning clinical outcomes. CONCLUSION: Dysregulated trace element homeostasis at baseline independently predicts adverse clinical outcomes in CD. The intricate relationship between trace elements and VAT could influence disease progression, suggesting potential targets for personalized treatment.