title: Reactive hyperaemia index as a marker of endothelial dysfunction in children with Crohn's disease is significantly lower than healthy controls.
abstract: OBJECTIVE
  Patients with inflammatory bowel disease (IBD) are prone to cardiovascular disorders, although there is little research to support this assertion, and other data are controversial in children. We aimed to determine the extent of premature atherosclerosis in Crohn's disease (CD) by measuring reactive hyperaemia index (RHI) as a functional marker of endothelial dysfunction (ED).
  
  
  METHODS
  Twenty-one patients with CD and twelve healthy matched subjects were enrolled in the study. Diagnosis was based on the standard clinical, endoscopic and histological criteria, including the Paediatric Crohn's disease Activity Index. ED was assessed using the plethysmographic RHI, combined with specific biochemical markers of ED.
  
  
  RESULTS
  RHI values were significantly lower in the patients with CD than the controls (p < 0.05). E-selectin (p < 0.05), asymmetric dimethylarginine (p < 0.01) and high-sensitive CRP (p < 0.05), but not vascular cells adhesive molecule-1 values, were significantly increased in the CD subjects compared with the control group.
  
  
  CONCLUSIONS
  Significantly decreased RHI and elevated plasma levels of specific biochemical parameters seems to be related to systemic inflammation and ED in children with CD. Our results support the hypothesis regarding RHI and ED in paediatric CD. This combined method assessment might be a useful tool for detection of ED and stratification of cardiovascular risk in patients with CD.
authors.affiliation: Department of Paediatrics, Faculty Hospital, Pilsen, Czech Republic; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic.
authors.forename: Jehlicka
authors.initials: J
authors.lastname: Petr
authors.forename: Huml
authors.initials: H
authors.lastname: Michal
authors.forename: Schwarz
authors.initials: S
authors.lastname: Jan
authors.forename: Trefil
authors.initials: T
authors.lastname: Ladislav
authors.forename: Kobr
authors.initials: K
authors.lastname: Jiri
authors.forename: Sykora
authors.initials: S
authors.lastname: Josef
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003424:Crohn Disease / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000150:complications / Q000503:physiopathology*; D008297:Male
chemical_list: D015415:Biomarkers
keywords: Asymmetric dimethylarginine; Crohn's disease; children; endothelial dysfunction reactive hyperaemia index