Abstract Background The long-term effects of sleep patterns, triglyceride-glucose index (TyG), and neutrophil-to-lymphocyte ratio (NLR) on the risk of developing Crohn’s disease (CD) and ulcerative colitis (UC) remain uncertain. Methods We conducted a prospective cohort study using data from the UK Biobank, which included 254,728 participants recruited between 2006 and 2010, with follow-up until the earliest occurrence of loss to follow-up, death, development of CD/UC, or the censoring date (October 14, 2022 for CD, and October 24, 2022 for UC). Multivariable Cox regression models were used to assess the associations between sleep patterns, TyG, NLR, and genetic susceptibility with CD and UC. Results The sleep score was constructed based on five sleep characteristics, with sleep patterns categorized into healthy sleep patterns (score ≥4), moderate sleep patterns (2≤ score ≤3), and poor sleep patterns (score ≤1). Unhealthy sleep patterns were defined as moderate and poor sleep patterns. Compared to participants with healthy sleep patterns, those with unhealthy sleep patterns had a 33% increased risk of developing CD (HR = 1.33, 95% CI: 1.12-1.59, P 0.05) and a 25% increased risk of developing UC (HR = 1.25, 95% CI: 1.10-1.41, P 0.05). Sensitivity analysis adjusted for immune-mediated inflammatory diseases (including asthma, rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis) and irritable bowel syndrome at baseline, and the results consistently indicated that unhealthy sleep patterns increase the risk of CD and UC. Elevated TyG and NLR both increase the risk of CD and UC, and they have an amplifying effect on the impact of unhealthy sleep patterns. Compared to participants with healthy sleep patterns and low genetic risk, those with unhealthy sleep patterns and high genetic risk had a 3.40-fold (95% CI: 2.22-5.20, P 0.05) and 3.41-fold (95% CI: 2.56-4.56, P 0.05) increased risk of CD and UC, respectively. Conclusion The prospective cohort study provides evidence that unhealthy sleep patterns increase the risk of developing CD and UC. Additionally, TyG, NLR, and genetic predisposition have a numerical amplification effect on the increased risk of CD and UC associated with sleep patterns. Conflict of interest: Mr. Feng, Ziqin: No conflict of interest Chen, Yanjun: No conflict of interest Song, Xiaohui: No conflict of interest Zhou, Shengtao: No conflict of interest Xie, Yitong: No conflict of interest Chen, Weichang: No conflict of interest
Feng et al. (Thu,) studied this question.