title: Increased arterial stiffness in inflammatory bowel diseases is dependent upon inflammation and reduced by immunomodulatory drugs.
abstract: BACKGROUND
  Inflammatory bowel diseases (IBD) are associated with an increased cardiovascular risk that is not fully explained by traditional cardiovascular risk factors but may be due to inflammation and mediated by an increased arterial stiffness.
  
  
  OBJECTIVE
  Study 1, to investigate the relationship between inflammation and arterial stiffening; Study 2, to look whether aortic stiffening is reduced by immunomodulatory therapy in IBD.
  
  
  METHODS
  Study 1 (Cross-sectional study): pulse wave velocity (PWV) was measured in 74 IBD subjects (40 ulcerative colitis and 34 Crohn's disease) and 80 matched controls. Study 2 (Longitudinal study): the effect of therapy on PWV was measured at baseline and 3.4 ± 0.5 years later in 14 IBD subjects treated only with salicylates, 11 subjects treated with steroids and azathioprine, 7 subjects treated with anti TNF-alpha and 30 matched controls.
  
  
  RESULTS
  Study 1: All parameters were comparable between subjects with ulcerative colitis and Crohn's disease. Compared to controls, subjects with ulcerative colitis and those with Crohn's disease have both higher carotid-femoral PWV (7.0 ± 1.1, 7.8 ± 1.7 and 8.0 ± 1.6 m/s, respectively; P < 0.001) and carotid-radial PWV (7.2 ± 0.9, 8.8 ± 1.4 and 8.8 ± 1.3 m/s, respectively; P < 0.001). In fully adjusted models carotid-femoral PWV was positively associated with disease duration whereas carotid-radial PWV was associated with C-reactive protein and history of relapse. Study 2: in fully adjusted model carotid-femoral PWV increased significantly at follow-up in IBD subjects treated with salicylates but not in those treated with steroids and azathioprine or anti TNF-alpha.
  
  
  CONCLUSIONS
  Increased arterial stiffness in IBD is dependent upon inflammation and reduced by immunomodulatory drugs.
authors.affiliation: Department of Internal Medicine, University of Catania, Italy. Electronic address: zanoli.rastelli@gmail.com.
authors.forename: Luca
authors.initials: L
authors.lastname: Zanoli
authors.affiliation: Department of Internal Medicine, University of Catania, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Rastelli
authors.affiliation: Department of Internal Medicine, University of Catania, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Inserra
authors.affiliation: Nephrology & Dialysis, San Bassiano Hospital, Bassano del Grappa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Lentini
authors.affiliation: Department of Emergence and Urgency Medicine, Umberto I Hospital, Siracusa, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Valvo
authors.affiliation: Department of Internal Medicine, University of Catania, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Calcagno
authors.affiliation: Department of Pharmacology, HEGP, AP-HP, INSERM U970, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Boutouyrie
authors.affiliation: Department of Pharmacology, HEGP, AP-HP, INSERM U970, Paris, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Laurent
authors.affiliation: Department of Internal Medicine, University of Catania, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellino
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D003424:Crohn Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000378:metabolism; D059289:Vascular Stiffness / Q000187:drug effects*; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents; D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Inflammation; Pulse wave velocity; TNF-alpha