Increased carotid intima-media thickness in patients with inflammatory bowel disease.
BACKGROUND
Patients with inflammatory bowel disease have an increased risk of thrombotic complications; moreover, mesenteric microvascular thrombosis has been hypothesized as a contributing factor in the pathogenesis of inflammatory bowel disease.


OBJECTIVE
To assess the extent of subclinical atherosclerosis in inflammatory bowel disease by measuring the intima-media thickness of the common carotid artery.


METHODS
Fifty-two patients were enrolled in the study. Patients aged >45 years, with a history of cardiovascular disease and known risk factors for atherosclerosis were excluded from the study. Twenty healthy subjects were studied as controls. Carotid ultrasonography was performed in all patients and controls. intima-media thickness was measured proximal to the carotid bifurcation over both right and left common carotid arteries. The clinical characteristics and the laboratory parameters relevant to disease activity were recorded for all inflammatory bowel disease patients. In particular, plasma homocysteine, a well-known risk factor for thrombosis, was assessed.


RESULTS
Common carotid artery intima-media thickness was significantly higher in inflammatory bowel disease patients (0.63 +/- 0.15 mm) compared with controls (0.53 +/- 0.08 mm). Multiple regression analysis revealed a significant association of carotid intima-media thickness with homocysteine levels and age.


CONCLUSIONS
Inflammatory bowel disease patients have an increased risk of early atherosclerosis than healthy controls as showed by greater values of carotid intima-media thickness. Homocysteine levels and age resulted independently associated with the increased arterial wall thickness.
Papa
A
A
Department of Internal Medicine, Gastroenterology Unit, Catholic University of Rome, Rome, Italy. apapa@rm.unicatt.it
Santoliquido
A
A
Danese
S
S
Covino
M
M
Di Campli
C
C
Urgesi
R
R
Grillo
A
A
Guglielmo
S
S
Tondi
P
P
Guidi
L
L
De Vitis
I
I
Fedeli
G
G
Gasbarrini
G
G
Gasbarrini
A
A
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology; D002784:Cholesterol / Q000097:blood; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006710:Homocysteine / Q000097:blood; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy; D000069285:Infliximab; D008297:Male; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D006710:Homocysteine; D002097:C-Reactive Protein; D002784:Cholesterol; D000069285:Infliximab