Abstract Background Metabolic syndrome (MetS) is highly prevalent worldwide, affecting up to one-third of adults. Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial lung disease, with a global prevalence of 17.7 per 100,000 persons. Given the ubiquity of MetS in general population, its coexistence with IPF is likely, and may influence disease outcomes. This study examined whether having both IPF and MetS worsens respiratory and metabolic outcomes compared to IPF without MetS, using real-world data. Methods The TriNetX Global Collaborative Network was queried to identify patients with IPF diagnosed between 1/2020-1/2025. MetS was defined by ≥ 3: type 2 diabetes mellitus, hypertension, dyslipidemia and BMI ≥ 30 kg/m2. Only 1.78% of participants had a recorded standard diagnostic code for MetS on TriNetX; therefore, proxy criteria were applied to identify additional cases. Comparison groups included: IPF with MetS vs IPF without MetS. Propensity score matching (PSM, 1:1) was used to make matched groups for age, gender, race, tobacco/alcohol use, emphysema, chronic obstructive pulmonary disease, chronic kidney disease. Key outcomes included major adverse cardiovascular events (MACE), major adverse liver outcomes (MALO), respiratory outcomes and all-cause mortality, and these were tracked up to 5 years. Results 21,800 patients diagnosed with IPF and MetS, and 20,834 patients with IPF without MetS were identified. After PSM, there were 17,018 patients in each group. Patients with IPF and MetS had a higher odds of acute respiratory failure (OR 1.5), chronic respiratory failure (OR 1.47), pulmonary hypertension (OR 1.41) and pulmonary embolism (OR 1.3). MACE risk was elevated in those with IPF and MetS group (OR 1.77). The risk of MALO, specifically ascites and encephalopathy were higher in patients with IPF with MetS (OR 1.45). Hospitalizations (OR 1.57) and all-cause mortality (OR 1.04) were increased in patients with IPF and MetS. Conclusions Presence of MetS in patients with IPF was associated with higher odds of adverse pulmonary, cardiovascular, liver-related outcomes, as well as increased mortality. These findings highlight the need for comprehensive cardiometabolic risk assessment and management in patients with IPF. This abstract is funded by: None
Rama et al. (Fri,) studied this question.