Wu Guo-Cui, Leng Rui-Xue, Lu Qi, Fan Yin-Guang, Wang De-Guang, Ye Dong-Qing
1 Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
2 Department of Clinical Medicine, The College of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China.
Angiology. 2017 May;68(5):447-461. doi: 10.1177/0003319716652031. Epub 2016 Jun 1.
We evaluated the differences in major markers of cardiovascular (CV) risk between inflammatory bowel diseases (IBDs) and controls by a systematic review and a meta-analysis. We searched PubMed, EMBASE, and Cochrane databases for literature comparing CV risk markers in IBDs and controls. The overall mean carotid intima-media thickness (CIMT), flow-mediated dilation (FMD%), and carotid-femoral pulse wave velocity (cfPWV) difference between patients with IBDs and control groups were calculated. Twenty-eight studies were included in the meta-analysis, including 16 studies with data on CIMT, 7 studies reporting FMD%, and 9 studies on cfPWV. Compared to controls, patients with IBDs showed significantly higher CIMT (standardized mean difference [ SMD]: 0.534 mm; 95% confidence interval [CI], 0.230 to 0.838; P = .001), significantly lower FMD% ( SMD, -0.721%; 95% CI, -1.020 to -0.421; P < .0001), and significantly increased cfPWV ( SMD, 0.849; 95% CI, 0.589 to 1.110; P < .0001). When analyzing subgroups with ulcerative colitis and Crohn disease (CD), all results were still significant except CIMT in CD. Our findings support the current evidence for an elevated CV burden in patients with IBD and support the clinical utility of markers of subclinical atherosclerosis in the management of these patients.
我们通过系统评价和荟萃分析评估了炎症性肠病（IBD）与对照组之间心血管（CV）风险主要标志物的差异。我们在PubMed、EMBASE和Cochrane数据库中检索了比较IBD与对照组CV风险标志物的文献。计算了IBD患者与对照组之间的总体平均颈动脉内膜中层厚度（CIMT）、血流介导的血管舒张（FMD%）以及颈股脉搏波速度（cfPWV）差异。荟萃分析纳入了28项研究，其中16项研究有CIMT数据，7项研究报告了FMD%，9项研究涉及cfPWV。与对照组相比，IBD患者的CIMT显著更高（标准化平均差[SMD]：0.534mm；95%置信区间[CI]，0.230至0.838；P = 0.001），FMD%显著更低（SMD，-0.721%；95%CI，-1.020至-0.421；P < 0.0001），cfPWV显著升高（SMD，0.849；95%CI，0.589至1.110；P < 0.0001）。在分析溃疡性结肠炎和克罗恩病（CD）亚组时，除CD组的CIMT外，所有结果仍然显著。我们的研究结果支持了目前关于IBD患者CV负担增加的证据，并支持亚临床动脉粥样硬化标志物在这些患者管理中的临床应用价值。
