Highlights
- •This study investigated expression of markers of subclinical atherosclerosis (ATS) in IBD.
- •Both IMT and arterial stiffness parameters (PWV and AIx) are increased in IBD patients.
- •Markers of ATS are significantly increased in patients on 5-ASA therapy only.
- •Therapies able to obtain a full control of inflammation may reverse also ATS risk in IBD.
- •Longitudinal studies are needed to confirm the correlation between ATS markers, inflammation and drug options in IBD.
Abstract
Background & Aims
Recent studies documented an increased cardiovascular risk in patients with inflammatory
bowel disease (IBD). Our study aimed at investigating the prevalence of intima-media
thickness (IMT) of the carotid arteries and the arterial stiffness indices as markers
of early atherosclerosis in young IBD patients.
Methods
We recruited 68 consecutive IBD patients, and 38 matched healthy controls less than
45 years old (median age 31.6 ± 8.1 years). Clinical and demographic features, cardiovascular risk factors, history of
cardiovascular events, concomitant therapies were registered on a dedicate database.
Carotid IMT was evaluated by using high resolution B-mode ultrasonography. Arterial
stiffness was assessed by measurement of carotid-femoral Pulse Wave Velocity (PWV)
and Augmentation Index (AIx).
Results
Total cholesterol (P < 0.013) and LDL-cholesterol (P < 0.019) levels were significantly lower in IBD patients compared to controls. Carotid
IMT was higher in IBD than in controls (P< 0.047), but there was no statistically significant difference among Crohn's Disease
(CD) and Ulcerative Colitis (UC) patients. Moreover, PWV and AIx were significantly
higher in patients as compared to controls (P < 0.006 and P < 0.004 respectively). No medication seemed to affect vascular measurements, though
stiffness parameters were significantly higher in patients treated with 5-ASA (11.9
(9.7) vs 18.2 (10.2), P < 0.021), suggesting a lack of efficacy of 5-ASA in protecting IBD patients from early
atherogenesis.
Conclusions
Young IBD patients show an increase in subclinical markers of atherosclerosis. Future
studies need to address whether these markers result in an increased risk of cardiovascular
events in these patient.
Abbreviations:
IBD (Inflammatory bowel disease), CD (Crohn's Disease), UC (Ulcerative Colitis), IMT (Intima media thickness), PWV (Pulse wave velocity), AIx (Augmentation index), DBP (Diastolic blood pressure), SBP (Systolic blood pressure), FMD (Flow mediated dilation), ESR (Erythrocyte-sedimentation rate), CRP (C-reactive protein)Keywords
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Article info
Publication history
Published online: November 01, 2016
Accepted:
October 6,
2016
Received in revised form:
October 1,
2016
Received:
August 24,
2016
Footnotes
☆Source of support: none.
Identification
Copyright
© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
