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Background Sitting, lying down, standing upright, and stepping is predominant behaviours occurring throughout the 24-day, yet have not been explored in ulcerative colitis (UC). The purpose of this study was to explore whether objectively measured time spent sitting, lying down, standing upright, and stepping was associated with endoscopic and biomarker-based disease severity in UC patients. Methods Patients were recruited from the Foothills Medical Center in Calgary, Alberta. Each patient wore an activPAL™ inclinometer (PAL Technologies Limited, Glasgow, UK) for 7 days (minimum 4 days, and on at least one weekend day). Disease severity was measured using Mayo endoscopic subscore and classified as either normal/mild or moderate/severe. Stool samples were collected and faecal calprotectin (FCP), a measure of gut inflammation, was measured. Serum C-reactive protein (CRP)], a marker of systemic inflammation, was collected. Univariate analysis of covariance (ANCOVA) was used to examine associations between activPALTM behavioural variables, Mayo endoscopic subscore, FCP (&amp;lt; or &amp;gt;250 mg/g) and CRP (&amp;lt; or &amp;gt;5 mg/l). All models were controlled for age, gender, body mass index, and antibiotic use. Results 21 patients (9 female, 12 male) consented to participate. Patients on average were 36 years of age (SD=8.9) and had a body mass index of 25.7 (2.4). For Mayo endoscopic subscore, 10 patients were normal/mild while 11 patients were moderate/severe. Mean FCP was 2288.6 (5453.9) and mean CRP was 4.9 (10.5). Per day, patients averaged 8443 (2731) steps, 497.6 (149.9) min sitting, 233.4 (72.9) min standing upright, and 536.3 (110.9) min lying down. Mayo endoscopic subscore was negatively associated with total number of steps (D=−3,331 steps, 95% CI: 5,450 to −1,212, p &amp;lt; .01), trended toward decreased upright standing time (D = −108 min/day, 95% CI: −208.2 to −7.7, p = 0.09), and positively with total sitting time (D = 121.2 min/day, 95% CI: −23.5 to 266, p = 0.09). FCP was negatively associated with standing time (D = −102.4 min/day, 95% CI: −206.3 to 1.6, p = .05), trended toward decreased total number of steps (D=−1,956 steps, 95% CI: −4,482 to 569, p = .12), and was not associated with total sitting time (D = 63.8 min/day, 95% CI: −87.8 to 215.4, p = .38). CRP was not associated with any of the activPALTM variables. Time spent lying down was not associated with any UC outcomes. Conclusion There was an association between objective measures of daily activity behaviours including total steps, standing time, sitting time and UC biomarkers of disease activity. Future studies should continue to examine daily activity behaviours and UC health outcomes in larger sample sizes.

journal of crohn's and colitis

P354 Objectively measured time spent sitting, standing upright, and stepping is associated with disease severity and faecal calprotectin in patients with ulcerative colitis