van Leuven Sander I, Hezemans Rachel, Levels Johannes H, Snoek Susan, Stokkers Pieter C, Hovingh G Kees, Kastelein John J P, Stroes Erik S, de Groot Eric, Hommes Daan W
Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Lipid Res. 2007 Dec;48(12):2640-6. doi: 10.1194/jlr.M700176-JLR200. Epub 2007 Sep 22.
A chronic inflammatory state is a risk factor for accelerated atherogenesis. The aim of our study was to explore whether Crohn's disease (CD), characterized by recurrent inflammatory episodes, is also associated with accelerated atherogenesis. In 60 CD patients and 122 matched controls, carotid intima media thickness (IMT), a validated marker for the burden and progression of atherosclerosis, was assessed ultrasonographically. Additional subgroup analyses, including plasma levels of acute phase reactants and HDL protein profiling, were performed in 11 consecutive patients with CD in remission, 10 patients with active CD, and 15 healthy controls. Carotid IMT in patients with CD was increased compared with healthy volunteers: 0.71 (0.17) versus 0.59 (0.14) mm (P < 0.0001), respectively. In the subgroup analysis, HDL levels in controls and patients in remission were identical [(1.45 (0.48) and 1.40 (0.46) mmol/l; P = 0.797], whereas HDL during exacerbation was profoundly reduced: 1.02 (0.33) (P = 0.022). HDL from patients with active CD and CD patients in remission was characterized by a reduced ability to attenuate oxidation compared with controls (P = 0.008 and P = 0.024 respectively). Patients with CD have increased IMT compared with matched controls, indicative of accelerated atherogenesis. The changes during CD exacerbation in terms of HDL concentration and composition imply a role for impaired HDL protection in these patients.
慢性炎症状态是动脉粥样硬化加速发展的一个危险因素。我们研究的目的是探讨以反复炎症发作为特征的克罗恩病（CD）是否也与动脉粥样硬化加速发展相关。对60例CD患者和122例匹配的对照者进行超声检查，评估颈动脉内膜中层厚度（IMT），这是一个用于评估动脉粥样硬化负荷和进展的有效指标。对11例连续缓解期的CD患者、10例活动期CD患者和15例健康对照者进行了额外的亚组分析，包括急性期反应物血浆水平和高密度脂蛋白（HDL）蛋白谱分析。与健康志愿者相比，CD患者的颈动脉IMT增加：分别为0.71（0.17）mm和0.59（0.14）mm（P<0.0001）。在亚组分析中，对照组和缓解期患者的HDL水平相同[（1.45（0.48）和1.40（0.46）mmol/L；P = 0.797]，而病情加重时HDL水平显著降低：1.02（0.33）（P = 0.022）。与对照组相比，活动期CD患者和缓解期CD患者的HDL减弱氧化的能力降低（分别为P = 0.008和P = 0.024）。与匹配的对照组相比，CD患者的IMT增加，表明动脉粥样硬化加速发展。CD病情加重期间HDL浓度和组成的变化表明HDL保护受损在这些患者中起作用。
