Journal of Kerman University of Medical Sciences

Current Issue

By Issue

By Author

Author Index

Keyword Index

About Journal

Aims and Scope

JKMU Ethical Policies

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

Metric

Editorial Policies

Data Sharing Policy

Evaluation of endothelial dysfunction via flow-mediated dilation (FMD) in patients with inflammatory bowel disease (IBD) referring to medical centers in Kerman

Document Type : Original Article

Authors

1 Clinical Research Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran

2 Gastroenterology Department, Kerman University of Medical Sciences, Kerman, Iran

3 Department of Radiology, Kerman University of Medical Sciences, Kerman, Iran

4 Endocrinology and Metabolism Research Center, Kerman University of Medical Sciences Kerman, Iran

5 Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran

6 Department of Anatomical Sciences, School of Medicine, Bam University of Medical Sciences (umbam), Bam, Iran

Abstract

Background: By examining flow-mediated dilation (FMD) as an index for indirect assessment of arterial endothelial function, this study aimed to investigate the relationship between inflammatory bowel disease (IBD) and early atherosclerosis.
Methods: This study was performed on 75 patients with ulcerative colitis, 15 patients with Crohn's disease, and 75 healthy individuals as the control group. Vascular endothelial function was assessed by flow-mediated dilation (FMD) and Doppler ultrasonography of the right brachial artery.
Results: The mean FMD in the IBD patients (12.04±3.8) was lower than that of the persons in the control group (16.68±2.2). Besides, the mean FMD in Crohn's patients was 12.02±3.5 and the corresponding value in the patients with ulcerative colitis was 12.07±4.2, showing no significant difference (p = 0.78). There was a significant relationship between age and FMD in the control group so that with increasing age, FMD decreased (r = 0.6, p = 0.01). However, there was no association between age and FMD among IBD patients.
Conclusion: Given that this study focused on people without known risk factors for atherosclerosis, the results pointed to endothelial dysfunction in IBD patients, and IBD can be considered as an independent factor in the development of atherosclerosis.

Keywords

Main Subjects

References
  1. Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142(1):46-54.e42. doi: 10.1053/j.gastro.2011.10.001.
  2. Lakatos L, Lakatos PL. Is the incidence and prevalence of inflammatory bowel diseases increasing in Eastern Europe? Postgrad Med J. 2006;82(967):332-7. doi: 10.1136/ pgmj.2005.042416.
  3. Safarpour AR, Hosseini SV, Mehrabani D. Epidemiology of inflammatory bowel diseases in Iran and Asia; a mini review. Iran J Med Sci. 2013;38(2 Suppl):140-9.
  4. Valdez R, Appelman HD, Bronner MP, Greenson JK. Diffuse duodenitis associated with ulcerative colitis. Am J Surg Pathol. 2000;24(10):1407-13. doi: 10.1097/00000478-200010000- 00011.
  5. Yantiss RK, Odze RD. Diagnostic difficulties in inflammatory bowel disease pathology. Histopathology. 2006;48(2):116- 32. doi: 10.1111/j.1365-2559.2005.02248.x.
  6. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105(3):501- 23. doi: 10.1038/ajg.2009.727.
  7. Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55(6):749-53. doi: 10.1136/gut.2005.082909.
  8. Brand S, Staudinger T, Schnitzler F, Pfennig S, Hofbauer K, Dambacher J, et al. The role of toll-like receptor 4 Asp299Gly and Thr399Ile polymorphisms and CARD15/NOD2 mutations in the susceptibility and phenotype of Crohn’s disease. Inflamm Bowel Dis. 2005;11(7):645-52. doi: 10.1097/01. mib.0000168372.94907.d2.
  9. Cummings JR, Ahmad T, Geremia A, Beckly J, Cooney R, Hancock L, et al. Contribution of the novel inflammatory bowel disease gene IL23R to disease susceptibility and phenotype. Inflamm Bowel Dis. 2007;13(9):1063-8. doi: 10.1002/ibd.20180.
  10. Beattie RM, Croft NM, Fell JM, Afzal NA, Heuschkel RB. Inflammatory bowel disease. Arch Dis Child. 2006;91(5):426- 32. doi: 10.1136/adc.2005.080481.
  11. Naser SA, Arce M, Khaja A, Fernandez M, Naser N, Elwasila S, et al. Role of ATG16L, NOD2 and IL23R in Crohn’s disease pathogenesis. World J Gastroenterol. 2012;18(5):412-24. doi: 10.3748/wjg.v18.i5.412.
  12. Silverberg MS, Cho JH, Rioux JD, McGovern DP, Wu J, Annese V, et al. Ulcerative colitis-risk loci on chromosomes 1p36 and 12q15 found by genome-wide association study. Nat Genet. 2009;41(2):216-20. doi: 10.1038/ng.275.
  13. Zhang SZ, Zhao XH, Zhang DC. Cellular and molecular immunopathogenesis of ulcerative colitis. Cell Mol Immunol. 2006;3(1):35-40.
  14. Schirbel A, Fiocchi C. Inflammatory bowel disease: established and evolving considerations on its etiopathogenesis and therapy. J Dig Dis. 2010;11(5):266-76. doi: 10.1111/j.1751- 2980.2010.00449.x.
  15. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352(16):1685-95. doi: 10.1056/NEJMra043430.
  16. Lin TY, Chen YG, Lin CL, Huang WS, Kao CH. Inflammatory bowel disease increases the risk of peripheral arterial disease: a nationwide cohort study. Medicine (Baltimore). 2015;94(52):e2381. doi: 10.1097/md.0000000000002381.
  17. Hatoum OA, Binion DG, Otterson MF, Gutterman DD. Acquired microvascular dysfunction in inflammatory bowel disease: loss of nitric oxide-mediated vasodilation. Gastroenterology. 2003;125(1):58-69. doi: 10.1016/s0016- 5085(03)00699-1.
  18. Ravikumar R, Deepa R, Shanthirani C, Mohan V. Comparison of carotid intima-media thickness, arterial stiffness, and brachial artery flow mediated dilatation in diabetic and nondiabetic subjects (The Chennai Urban Population Study [CUPS-9]). Am J Cardiol. 2002;90(7):702-7. doi: 10.1016/ s0002-9149(02)02593-6.
  19. Matsuura E, Atzeni F, Sarzi-Puttini P, Turiel M, Lopez LR, Nurmohamed MT. Is atherosclerosis an autoimmune disease? BMC Med. 2014;12:47. doi: 10.1186/1741-7015-12-47.
  20. Libby P, Lichtman AH, Hansson GK. Immune effector mechanisms implicated in atherosclerosis: from mice to humans. Immunity. 2013;38(6):1092-104. doi: 10.1016/j. immuni.2013.06.009.
  21. Ng SC. Epidemiology of inflammatory bowel disease: focus on Asia. Best Pract Res Clin Gastroenterol. 2014;28(3):363- 72. doi: 10.1016/j.bpg.2014.04.003.
  22. Zanoli L, Rastelli S, Inserra G, Castellino P. Arterial structure and function in inflammatory bowel disease. World J Gastroenterol. 2015;21(40):11304-11. doi: 10.3748/wjg.v21. i40.11304.
  23. Roifman I, Sun YC, Fedwick JP, Panaccione R, Buret AG, Liu H, et al. Evidence of endothelial dysfunction in patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2009;7(2):175-82. doi: 10.1016/j.cgh.2008.10.021.
  24. Cappello M, Licata A, Calvaruso V, Bravatà I, Aiello A, Torres D, et al. Increased expression of markers of early atherosclerosis in patients with inflammatory bowel disease. Eur J Intern Med. 2017;37:83-9. doi: 10.1016/j.ejim.2016.10.004.
  25. Papa A, Danese S, Urgesi R, Grillo A, Guglielmo S, Roberto I, et al. Early atherosclerosis in patients with inflammatory bowel disease. Eur Rev Med Pharmacol Sci. 2006;10(1):7-11.
  26. Charakida M, Masi S, Lüscher TF, Kastelein JJ, Deanfield JE. Assessment of atherosclerosis: the role of flow-mediated dilatation. Eur Heart J. 2010;31(23):2854-61. doi: 10.1093/ eurheartj/ehq340.
  27. Peretz A, Leotta DF, Sullivan JH, Trenga CA, Sands FN, Aulet MR, et al. Flow mediated dilation of the brachial artery: an investigation of methods requiring further standardization. BMC Cardiovasc Disord. 2007;7:11. doi: 10.1186/1471- 2261-7-11.
  28. Benjamin EJ, Larson MG, Keyes MJ, Mitchell GF, Vasan RS, Keaney JF Jr, et al. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham Heart Study. Circulation. 2004;109(5):613-9. doi: 10.1161/01. cir.0000112565.60887.1e.
  29. Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology. 2004;126(6):1504-17. doi: 10.1053/j.gastro.2004.01.063.
  30. Rungoe C, Nyboe Andersen N, Jess T. Inflammatory bowel disease and risk of coronary heart disease. Trends Cardiovasc Med. 2015;25(8):699-704. doi: 10.1016/j.tcm.2015.03.010.
  31. Andreozzi M, Giugliano FP, Strisciuglio T, Pirozzi E, Papparella A, Caprio AM, et al. The role of inflammation in the endothelial dysfunction in a cohort of pediatric patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2019;69(3):330-5. doi: 10.1097/mpg.0000000000002374.
  32. Ozturk K, Guler AK, Cakir M, Ozen A, Demirci H, Turker T, et al. Pulse wave velocity, intima media thickness, and flow-mediated dilatation in patients with normotensive normoglycemic inflammatory bowel disease. Inflamm Bowel Dis. 2015;21(6):1314-20. doi: 10.1097/ mib.0000000000000355.
  33. Principi M, Mastrolonardo M, Scicchitano P, Gesualdo M, Sassara M, Guida P, et al. Endothelial function and cardiovascular risk in active inflammatory bowel diseases. J Crohns Colitis. 2013;7(10):e427-33. doi: 10.1016/j. crohns.2013.02.001.
  34. Kayahan H, Sari I, Cullu N, Yuksel F, Demir S, Akarsu M, et al. Evaluation of early atherosclerosis in patients with inflammatory bowel disease. Dig Dis Sci. 2012;57(8):2137- 43. doi: 10.1007/s10620-012-2148-x.
  35. Best WR. Predicting the Crohn’s disease activity index from the Harvey-Bradshaw Index. Inflamm Bowel Dis. 2006;12(4):304- 10. doi: 10.1097/01.MIB.0000215091.77492.2a.
  36. Cooney RM, Warren BF, Altman DG, Abreu MT, Travis SP. Outcome measurement in clinical trials for ulcerative colitis: towards standardisation. Trials. 2007;8:17. doi: 10.1186/1745-6215-8-17.
  37. Tan ST, Scott W, Panoulas V, Sehmi J, Zhang W, Scott J, et al. Coronary heart disease in Indian Asians. Glob Cardiol Sci Pract. 2014;2014(1):13-23. doi: 10.5339/gcsp.2014.4.
  38. Raji-Amirhasani A, Joukar S, Naderi-Boldaji V, Bejeshk MA. Mild exercise along with limb blood-flow restriction modulates the electrocardiogram, angiotensin, and apelin receptors of the heart in aging rats. Iran J Basic Med Sci. 2018;21(6):558-63. doi: 10.22038/ijbms.2018.24796.6165.
  39. Wu H, Xu M, Hao H, Hill MA, Xu C, Liu Z. Endothelial dysfunction and arterial stiffness in patients with inflammatory bowel disease: a systematic review and meta-analysis. J Clin Med. 2022;11(11):3179. doi: 10.3390/jcm11113179.
  40. Gravina AG, Dallio M, Masarone M, Rosato V, Aglitti A, Persico M, et al. Vascular endothelial dysfunction in inflammatory bowel diseases: pharmacological and nonpharmacological targets. Oxid Med Cell Longev. 2018;2018:2568569. doi: 10.1155/2018/2568569.
  41. Kristensen SL, Ahlehoff O, Lindhardsen J, Erichsen R, Jensen GV, Torp-Pedersen C, et al. Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study. PLoS One. 2013;8(2):e56944. doi: 10.1371/journal.pone.0056944.
  42. Cibor D, Domagala-Rodacka R, Rodacki T, Jurczyszyn A, Mach T, Owczarek D. Endothelial dysfunction in inflammatory bowel diseases: pathogenesis, assessment and implications. World J Gastroenterol. 2016;22(3):1067-77. doi: 10.3748/wjg.v22.i3.1067.
  43. Ferreira-Duarte M, Sousa JB, Diniz C, Sousa T, Duarte- Araújo M, Morato M. Experimental and clinical evidence of endothelial dysfunction in inflammatory bowel disease. Curr Pharm Des. 2020;26(30):3733-47. doi: 10.2174/138161282 6666200701212414.
Journal of Kerman University of Medical Sciences
Volume 31, Issue 2 - Serial Number 2
May and June 2024
Pages 55-59
Files
Share
How to cite
Statistics