Department of Internal and Emergency Medicine, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2017 Dec;21(23):5437-5444. doi: 10.26355/eurrev_201712_13932.
The aim of this review is to explore the evidence about the association among celiac disease (CD), atherosclerosis (AS) and cardiovascular (CV) diseases, and the role of inflammation in this connection.
A systematic literature search was conducted using PubMed, EMBASE, and Cochrane Library for the association among CD, AS and CV diseases.
Several studies reported the association of CD with accelerated AS, as evidenced by the alterations of a number of parameters indicative of subclinical AS, as increased carotid artery intima-media thickness, endothelial dysfunction and increased arterial stiffness. In addition, recent evidence reported an increase of CV diseases prevalence in CD patients respect to controls, many of which including ischemic diseases as acute myocardial infarction and angina pectoris, as well as death from ischemic heart disease, and, more rarely, stroke for cerebrovascular involvement. Other not-ischemic CV diseases associated with CD are represented by dilated cardiomyopathy, atrial fibrillation, and myocarditis.
On the basis of the reported association among CD, AS and CV diseases, we suggest to perform a more detailed CV risk assessment in all CD patients than what is currently being achieved in clinical practice, in order to scan and treat modifiable CV risk factors in these patients. In particular, we suggest to resort to instrumental techniques to detect AS in the subclinical stage, in order to prevent AS development and CV diseases in CD patients.
本综述旨在探讨乳糜泻（CD）、动脉粥样硬化（AS）和心血管（CV）疾病之间的关联证据，以及炎症在这方面的作用。
使用 PubMed、EMBASE 和 Cochrane Library 对 CD、AS 和 CV 疾病之间的关联进行了系统的文献检索。
几项研究报告了 CD 与加速 AS 的关联，这表现在许多提示亚临床 AS 的参数发生改变，如颈动脉内膜中层厚度增加、内皮功能障碍和动脉僵硬度增加。此外，最近的证据报告称，与对照组相比，CD 患者的 CV 疾病患病率增加，其中许多包括缺血性疾病，如急性心肌梗死和心绞痛，以及因缺血性心脏病导致的死亡，以及更罕见的因脑血管受累导致的中风。与 CD 相关的其他非缺血性 CV 疾病包括扩张型心肌病、心房颤动和心肌炎。
基于报告的 CD、AS 和 CV 疾病之间的关联，我们建议对所有 CD 患者进行比目前临床实践更详细的 CV 风险评估，以扫描和治疗这些患者的可改变 CV 危险因素。特别是，我们建议利用仪器技术在亚临床阶段检测 AS，以预防 CD 患者的 AS 发展和 CV 疾病。
