Lipid and phospholipid profile after bowel resection for Crohn's disease.
OBJECTIVE
Chronic inflammation, impaired intestinal adsorption, and bowel resection may have an impact on lipid metabolism before and after intestinal surgery for Crohn's disease (CD). The aim of this prospective study was to define the impact of intestinal surgery for CD on plasma phospholipid fatty acid (FA) composition and of serum plasma lipoprotein concentrations and to investigate the role of CD recurrence on lipid parameters.


METHODS
Twenty-four consecutive patients who had intestinal surgery for CD since December 2004 to March 2006 were enrolled in this prospective study. The total amount of calorie intake and the quality of the aliments, systemic inflammatory activity, and plasma lipoproteins and phospholipid fatty acid composition were determined at operation and at follow-up. Statistical analysis was performed with pair-matched tests.


RESULTS
The median follow-up was 6 (4-20) months. During the follow-up, no significant modification of body mass index was observed. An increase of high-density lipoprotein (HDL) cholesterol (p=0.02) without other modifications in the plasma phospholipid FA composition were evidenced after surgery. The comparison between colectomy and ileo-colonic or ileal resection groups did not show any significant difference in the lipoprotein concentration and phospholipid FA profile. The length of resected bowel did not show any significant correlation with any relevant difference in lipid, phospholipid profile, or in inflammatory parameters. Patients who experienced a recurrence of CD reported significantly higher levels of total (p<0.01), HDL (p=0.01), and low-density lipoprotein cholesterol (p=0.01) were observed in patients in remission than in those with recurrent active disease.


CONCLUSIONS
Patients who are submitted to intestinal resection for CD improve their inflammatory status as well as their lipid metabolism, and CD recurrence, but not the extent of bowel resection, is the main predictor of alteration of serum lipid concentration.
Romanato
Giovanna
G
Aging Section, CNR-Institute of Neurosciences, via Giustiniani 2, 35128 Padua, Italy. giovanna.romanato@unipd.it
Scarpa
Marco
M
Ruffolo
Cesare
C
Marin
Raffaella
R
Zambon
Sabina
S
Zanoni
Silvia
S
Basato
Silvia
S
Filosa
Teresa
T
Pilon
Fabio
F
Angriman
Imerio
I
Manzato
Enzo
E
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003082:Colectomy / Q000379:methods*; D003424:Crohn Disease / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005231:Fatty Acids, Unsaturated / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D055815:Young Adult
D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005231:Fatty Acids, Unsaturated