Aortic stiffness in patients with inflammatory bowel diseases

Eleni Theocharidou, Melachrini Mavroudi, Konstantinos Soufleris, Theodora Griva, Olga Giouleme, Vasilios G. Athyros, Asterios Karagiannis



Background: Inflammation is an independent risk factor for cardiovascular disease (CVD). CVD risk in patients with inflammatory bowel diseases (IBD) has been investigated in few studies with contradictory results. Aortic stiffness, assessed by measuring pulse wave velocity (PWV), is associated with CVD risk. The aim of this study was to assess carotid-femoral PWV in patients with IBD without history of CVD compared with controls.
Methods: Traditional CVD risk factors and IBD characteristics were assessed in 66 patients with IBD, 43 with Crohn’s disease (CD) and 23 with ulcerative colitis (UC), and 44 controls. PWV was measured using the SphygmoCor system. Parameters associated with PWV were identified by linear regression.
Results: There were 29 men (43.9%) in the IBD group and 20 (45.5%) in the control group. The median age was 38 years in both groups. There were 32 smokers (48.5%) in the IBD group and 20 (45.5%) in the control group. 60% of patients had mild disease pattern, and 74% were in remission at the time of the study. IBD patients had lower haemoglobin, total cholesterol, low density lipoprotein cholesterol (LDL-C) and folic acid levels, and higher platelet count. There was no difference in PWV between patients and controls (6.6 ± 1.3 vs 6.1 ± 0.9 m/s, p = 0.247), or between patients with CD and UC (6.8 ± 1.3 vs 6.3 ± 1.1 m/s, p = 0.108), although smoking rates were significantly higher in CD patients. Factors associated with PWV were age, BMI, mean arterial pressure and smoking, with age making the greater unique contribution.
Conclusions: Our study showed no difference in PWV between patients with IBD and controls. This might be due to lack of association between IBD and CVD risk, or the inclusion of patients with low inflammatory burden and low LDL-C, which are less likely to exhibit early arterial wall changes. Further studies are required to investigate such an association.

Keywords: inflammatory bowel diseases, cardiovascular disease, aortic stiffness, pulse wave velocity, atherosclerosis