Evaulation of early atherosclerosis in patients with inflammatory bowel disease

OBJECTİVESThere are several studies about the chronic inflammatory diseases might be associated with accelerated atherosclerotic process. However, the data regarding effect of chronic inflammation on endothelial dysfunction is very limited in patients with IBD. In this study the role of IBD as a risk factor for the development of endothelial dysfunction was evaluated in clinically inactive IBD group.METHODSBrachial artery FMD and common carotid artery IMT were evaluated by USG in 39 IBD patients mean age 34.2 ± 9.6 years (20 Crohn?s disease mean CDAI 62.3 ± 26.3 and 19 Ulcerative colitis patients mean MTWK: 2.7 ± 2.2) and in 31 healthy donors (mean age 32.3 ± 5.9 years) matched for age, sex and smoking status. High sensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), solubl CD40 ligand (sCD40L), interleukin (IL)-18, homocystein and plasminogen activator-inhibitor-1 (PAI-1) were measured. According to the variable distribution, Student t-test or Mann?Whitney U-test was used for comparison of groups. Categorical variables were compared by using the chi-square test. Pearson?s correlation analysis was also performed.RESULTSThere was no difference in IMT of common carotid artery between IBD and control group (0.52 ± 0.07 vs 0.51 ± 0.05 p=0.822), while both endothelial dependent (11.90 ± 6.12 vs 18.60 ± 9.40 p=0.002) and independent (17.04 ± 6.79 vs 21.39 ± 9.79 p=0.048) dilatation response were impaired in IBD patients compared to the control group. Inflammatory markers (ESR, hsCRP, sCD40L, IL-18) were significantly elevated in IBD patients compared with controls (p <0.05). PAI-1 levels were decreased in IBD group compared to controls (16.4 ± 13.2 vs 26.3 ± 10.6 p=0.002). Homocystein levels were similar in both groups (p >0.05). Endothelial dependent dilatation values were significantly negative correlated with sCD40L levels (r=-0.325 p=0.010).CONCLUSIONIn our study, we demonstrated that subjects with inactive IBD had impaired FMD while increased IMT of common carotid artery which is seen in the late stage of early atherosclerosis was not found. Only sCD40L levels were correlated with endothelial dependent dilatation. sCD40L may be a common pathogenetic factor both of IBD and atherosclerosis.KEY WORDS: Inflammatory bowel disease, endothelial dysfunction, intima-media thickness, atherosclerosis