title: Enhanced atherogenesis and altered high density lipoprotein in patients with Crohn's disease.
abstract: A chronic inflammatory state is a risk factor for accelerated atherogenesis. The aim of our study was to explore whether Crohn's disease (CD), characterized by recurrent inflammatory episodes, is also associated with accelerated atherogenesis. In 60 CD patients and 122 matched controls, carotid intima media thickness (IMT), a validated marker for the burden and progression of atherosclerosis, was assessed ultrasonographically. Additional subgroup analyses, including plasma levels of acute phase reactants and HDL protein profiling, were performed in 11 consecutive patients with CD in remission, 10 patients with active CD, and 15 healthy controls. Carotid IMT in patients with CD was increased compared with healthy volunteers: 0.71 (0.17) versus 0.59 (0.14) mm (P < 0.0001), respectively. In the subgroup analysis, HDL levels in controls and patients in remission were identical [(1.45 (0.48) and 1.40 (0.46) mmol/l; P = 0.797], whereas HDL during exacerbation was profoundly reduced: 1.02 (0.33) (P = 0.022). HDL from patients with active CD and CD patients in remission was characterized by a reduced ability to attenuate oxidation compared with controls (P = 0.008 and P = 0.024 respectively). Patients with CD have increased IMT compared with matched controls, indicative of accelerated atherogenesis. The changes during CD exacerbation in terms of HDL concentration and composition imply a role for impaired HDL protection in these patients.
authors: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. s.i.vanleuven@amc.uva.nl
authors: Sander I
authors: SI
authors: van Leuven
authors: Rachel
authors: R
authors: Hezemans
authors: Johannes H
authors: JH
authors: Levels
authors: Susan
authors: S
authors: Snoek
authors: Pieter C
authors: PC
authors: Stokkers
authors: G Kees
authors: GK
authors: Hovingh
authors: John J P
authors: JJ
authors: Kastelein
authors: Erik S
authors: ES
authors: Stroes
authors: Eric
authors: E
authors: de Groot
authors: Daan W
authors: DW
authors: Hommes
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D008075:Lipoproteins, HDL