Rybak Anna, Wierzbicka Aldona, Socha Piotr, Stolarczyk Anna, Cukrowska Bożena, Obrycki Łukasz, Wawer Zbigniew, Janas Roman, Oralewska Beata, Szaflarska-Popławska Anna, Iwańczak Barbara, Cyrta-Jarocka Elżbieta, Grzybowska-Chlebowczyk Urszula, Cichy Wojciech, Czaja-Bulsa Grażyna, Socha Jerzy
Department of Gastroenterology, The Great Ormond Street Hospital, London, UK.
Department of Biochemistry and Experimental Medicine, Children's Memorial Health Institute, Warsaw, Poland.
Gastroenterol Res Pract. 2020 Mar 27;2020:6138243. doi: 10.1155/2020/6138243. eCollection 2020.
We found significantly lower concentrations of total cholesterol, lipoprotein LDL-C, apolipoproteins A1 and B, as well as hCRP in all children with CD. We showed decreased level (<5 ng/mL) of folic acid among 46% of children treated for >5 years. Moreover, we showed significant decrease of folic acid level already after 1 year of a GFD (12 . 5.6 ng/mL; < 0.001). We also found significant negative correlation of -score body mass index (BMI) with HDL and APOA1 level ( = -0.33; = 0.015 and = -0.28; = 0.038, respectively) and modest positive correlation of -score BMI with atherogenic factor of total cholesterol-HDL ratio and LDL-HDL ratio ( = 0.40; = 0.002 and = 0.36; = 0.006, respectively). Analysis of physical activity showed an increase in the insulin levels with inactivity ( = 0.36; = 0.0025). We also found positive correlation of the sleep duration with the adiponectin level ( = 0.41; = 0.011).
In children with CD treated with a GFD, decreased level of folic acid together with increased BMI, sedentary behavior, and an improper lipid profile may predispose them to atherosclerosis in the long run. This data suggests the need of further studies to determine the need for metabolic cardiovascular risk screening in children with CD.
我们发现，所有克罗恩病患儿的总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1和B以及超敏C反应蛋白的浓度均显著降低。我们发现，在接受治疗超过5年的患儿中，46%的患儿叶酸水平降低（<5 ng/mL）。此外，我们还发现，采用无谷蛋白饮食（GFD）1年后，叶酸水平就显著下降（12.5.6 ng/mL；P<0.001）。我们还发现，体重指数（BMI）z评分与高密度脂蛋白（HDL）和载脂蛋白A1水平呈显著负相关（分别为r = -0.33，P = 0.015和r = -0.28，P = 0.038），而BMI z评分与总胆固醇-HDL比值和LDL-HDL比值的致动脉粥样硬化因子呈适度正相关（分别为r = 0.40，P = 0.002和r = 0.36，P = 0.006）。体力活动分析显示，不活动时胰岛素水平升高（r = 0.36，P = 0.0025）。我们还发现，睡眠时间与脂联素水平呈正相关（r = 0.41，P = 0.011）。
对于采用GFD治疗的克罗恩病患儿，叶酸水平降低、BMI增加、久坐不动的行为以及脂质谱异常可能会使他们长期易患动脉粥样硬化。该数据表明，需要进一步研究以确定对克罗恩病患儿进行代谢性心血管风险筛查的必要性。
