title: Evidence of endothelial dysfunction in patients with inflammatory bowel disease.
abstract: 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.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Idan
authors.initials: I
authors.lastname: Roifman
authors.forename: Yichun C
authors.initials: YC
authors.lastname: Sun
authors.forename: Jason P
authors.initials: JP
authors.lastname: Fedwick
authors.forename: Remo
authors.initials: R
authors.lastname: Panaccione
authors.forename: Andre G
authors.initials: AG
authors.lastname: Buret
authors.forename: Hongqun
authors.initials: H
authors.lastname: Liu
authors.forename: Alaa
authors.initials: A
authors.lastname: Rostom
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Anderson
authors.forename: Paul L
authors.initials: PL
authors.lastname: Beck
mesh_terms: 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