Evidence of endothelial dysfunction in patients with inflammatory bowel disease.
OBJECTIVE
Chronic inflammation has a major role in the development and propagation of endothelial dysfunction, which can lead to coronary artery disease. Endothelial dysfunction has been described in patients with various and diverse chronic inflammatory conditions. Altered vascular flow has been proposed to mediate inflammation in inflammatory bowel disease (IBD), although the role of endothelial dysfunction remains obscure. The purpose of our study was to assess endothelial function in patients with IBD.


METHODS
Ninety-eight subjects were included in this study; 48 with IBD (17 with ulcerative colitis and 31 with Crohn's disease) and 50 healthy controls. Endothelial function was assessed by pulse arterial tonometry (PAT) and brachial ultrasound to determine flow-mediated dilation and shear stress reactive hyperemia. The impact of disease activity, disease duration, and IBD therapy also was assessed.


RESULTS
Baseline demographic characteristics, including cardiovascular risk factors, were similar in all groups. IBD patients showed microvascular endothelial dysfunction, with lower PAT indices (P < .01) and shear stress reactive hyperemia (P < .05) compared with controls. There was no relationship between microvascular endothelial dysfunction, disease duration, underlying therapy, or clinical disease activity. There was a positive association between lower PAT scores and recent abdominal pain (P < .05).


CONCLUSIONS
This was a large study assessing endothelial dysfunction in IBD. Both ulcerative colitis and Crohn's disease patients showed evidence of microvascular endothelial dysfunction. Future research could determine whether endothelial dysfunction is involved in the pathogenesis of IBD or increases the risk of cardiovascular events in this patient population.
Roifman
Idan
I
Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Sun
Yichun C
YC
Fedwick
Jason P
JP
Panaccione
Remo
R
Buret
Andre G
AG
Liu
Hongqun
H
Rostom
Alaa
A
Anderson
Todd J
TJ
Beck
Paul L
PL
D000328:Adult; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000473:pathology*; D008297:Male; D008365:Manometry; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional