Increased levels of lipoprotein (a) in Crohn's disease: a relation to thrombosis?
OBJECTIVE
Lipoprotein (a) is recognized as a risk factor for arterial and venous thrombosis, a property that might be related to its structural similarity to plasminogen. Since patients with inflammatory bowel disease frequently suffer from thromboembolic events, we studied the role of lipoprotein (a) in conjunction with lipids and apolipoproteins in Greek patients with ulcerative colitis and Crohn's disease.


METHODS
Lipoprotein (a), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A-1 and apolipoprotein B-100 were determined in sera from 129 consecutive fasting Greek patients with inflammatory bowel disease (66 with ulcerative colitis and 63 with Crohn's disease) and from 66 matched healthy controls.


RESULTS
In Crohn's disease patients, the mean serum lipoprotein (a) level was significantly higher than in control patients (41.2 mg/dl vs 22.9 mg/dl; P = 0.005). Mean apolipoprotein A-1 and apolipoprotein B-100 levels were significantly lower in Crohn's disease patients than in the controls. In ulcerative colitis patients the mean levels of lipoprotein (a) and apolipoprotein A-1 were not significantly different to the controls, but the levels of apolipoprotein B-100 were significantly lower. Raised levels of lipoprotein (a) of > 30 mg/dl were found in 29 Crohn's disease patients (46%), 15 ulcerative colitis patients (23%) and 11 control patients (17%). Patients with active Crohn's disease had significantly higher mean lipoprotein (a) and lower apolipoprotein A-1 than patients with non-active disease.


CONCLUSIONS
Our results suggest that Crohn's disease patients have different lipoprotein (a) and apolipoprotein patterns compared to ulcerative colitis patients and healthy controls. These changes in Crohn's disease patients may possibly expose them to a higher risk of thrombosis.
Koutroubakis
I E
IE
Department of Gastroenterology, University Hospital Heraklion, Crete, Greece. ktjohn@her.forthnet.gr
Malliaraki
N
N
Vardas
E
E
Ganotakis
E
E
Margioris
A N
AN
Manousos
O N
ON
Kouroumalis
E A
EA
D000328:Adult; D001053:Apolipoproteins / Q000097:blood; D016022:Case-Control Studies; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D005260:Female; D006115:Greece; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood / Q000209:etiology*
D001053:Apolipoproteins; D017270:Lipoprotein(a)