Zanoli Luca, Rastelli Stefania, Inserra Gaetano, Lentini Paolo, Valvo Enrico, Calcagno Emanuela, Boutouyrie Pierre, Laurent Stephane, Castellino Pietro
Department of Internal Medicine, University of Catania, Italy.
Department of Internal Medicine, University of Catania, Italy.
Atherosclerosis. 2014 Jun;234(2):346-51. doi: 10.1016/j.atherosclerosis.2014.03.023. Epub 2014 Mar 30.
Inflammatory bowel diseases (IBD) are associated with an increased cardiovascular risk that is not fully explained by traditional cardiovascular risk factors but may be due to inflammation and mediated by an increased arterial stiffness.
Study 1, to investigate the relationship between inflammation and arterial stiffening; Study 2, to look whether aortic stiffening is reduced by immunomodulatory therapy in IBD.
Study 1 (Cross-sectional study): pulse wave velocity (PWV) was measured in 74 IBD subjects (40 ulcerative colitis and 34 Crohn's disease) and 80 matched controls. Study 2 (Longitudinal study): the effect of therapy on PWV was measured at baseline and 3.4 ± 0.5 years later in 14 IBD subjects treated only with salicylates, 11 subjects treated with steroids and azathioprine, 7 subjects treated with anti TNF-alpha and 30 matched controls.
Study 1: All parameters were comparable between subjects with ulcerative colitis and Crohn's disease. Compared to controls, subjects with ulcerative colitis and those with Crohn's disease have both higher carotid-femoral PWV (7.0 ± 1.1, 7.8 ± 1.7 and 8.0 ± 1.6 m/s, respectively; P < 0.001) and carotid-radial PWV (7.2 ± 0.9, 8.8 ± 1.4 and 8.8 ± 1.3 m/s, respectively; P < 0.001). In fully adjusted models carotid-femoral PWV was positively associated with disease duration whereas carotid-radial PWV was associated with C-reactive protein and history of relapse. Study 2: in fully adjusted model carotid-femoral PWV increased significantly at follow-up in IBD subjects treated with salicylates but not in those treated with steroids and azathioprine or anti TNF-alpha.
Increased arterial stiffness in IBD is dependent upon inflammation and reduced by immunomodulatory drugs.
炎症性肠病（IBD）与心血管疾病风险增加相关，传统心血管危险因素并不能完全解释这一现象，可能是由于炎症以及动脉僵硬度增加所致。
研究1，调查炎症与动脉僵硬度之间的关系；研究2，观察免疫调节治疗是否能降低IBD患者的主动脉僵硬度。
研究1（横断面研究）：对74例IBD患者（40例溃疡性结肠炎和34例克罗恩病）和80例匹配的对照者测量脉搏波速度（PWV）。研究2（纵向研究）：在基线及3.4±0.5年后，对14例仅接受水杨酸盐治疗的IBD患者、11例接受类固醇和硫唑嘌呤治疗的患者、7例接受抗TNF-α治疗的患者以及30例匹配的对照者测量治疗对PWV的影响。
研究1：溃疡性结肠炎患者和克罗恩病患者的所有参数均具有可比性。与对照组相比，溃疡性结肠炎患者和克罗恩病患者的颈股PWV均较高（分别为7.0±1.1、7.8±1.7和8.0±1.6 m/s；P<0.001），颈桡PWV也较高（分别为7.2±0.9、8.8±1.4和8.8±1.3 m/s；P<0.001）。在完全调整模型中，颈股PWV与病程呈正相关，而颈桡PWV与C反应蛋白和复发史相关。研究2：在完全调整模型中，接受水杨酸盐治疗的IBD患者随访时颈股PWV显著增加，而接受类固醇和硫唑嘌呤或抗TNF-α治疗的患者则未增加。
IBD患者动脉僵硬度增加取决于炎症，免疫调节药物可降低其程度。
