Abstract
BACKGROUND: The impact of metabolic syndrome (MetS) and its components on Crohn's disease (CD) remains unclear. This study investigated how individual MetS factors and cumulative metabolic burden affect CD activity and outcomes. METHODS: This retrospective study was conducted at a tertiary care hospital and encompassed a cohort of 376 hospitalized patients diagnosed with CD from 2015 to 2025. Linear, logistic, and Poisson regression models assessed correlations between MetS elements and clinical indicators, evaluating how their presence and number affected CD. RESULTS: Thirty-six patients (9.6%) had MetS. Compared to non-MetS patients, those with MetS exhibited a significantly higher Simple Endoscopic Score for CD (10 vs. 7; p < 0.001), Crohn's Disease Activity Index (294.3 vs. 256.6; p < 0.001), risks of complications (OR = 8.65, 95% CI: 2.01-37.26, p = 0.004) and surgery or invasive procedures (OR = 2.64, 95% CI: 1.27-5.45, p = 0.009). Low high-density lipoprotein cholesterol conferred a higher risk of adverse outcomes. The cumulative number of MetS elements exhibited an incremental effect, with increasing numbers correlating to progressively higher disease severity and a risk of poor outcomes. CONCLUSION: The concurrent presence of multiple MetS elements can synergistically worsen the clinical course of CD. Management of these components is crucial for the long-term prognosis of CD.