Endothelial function and cardiovascular risk in patients with inflammatory bowel disease in remission phase

To the editorUlcerative colitis (UC) and Crohn’s disease (CD)are the main chronic inflammatory disorders ofdigestive tract (inflammatory bowel disease [IBD])[1]. There is evidence that patients with IBD are atincreased thrombotic risk compared to generalpopulation since it has been demonstrated that IBDare associated with subclinical atherosclerosis,endothelial dysfunction and increased carotidintima-media thickness [2,3]. Intestinal vessels mayshow a microvascular endothelial dysfunction in IBD,which correlates to intestinal activity. In a previousstudy [4], we demonstrated that subjects sufferingfrom IBD in an active phase show an endothelialdysfunction, measured by brachial flow-mediateddilatation (FMD). Therefore, we report here resultsabout the endothelial function assessed by FMD in agroup of IBD patients in remission phase.A total of 58 (men/female: 30/28, mean age 43.95 ±15.15 years) patients with IBD, 29 CD and 29 UC,were recruited. Forty healthy controls matched forgender and age were enrolled. Diagnosis was basedon standard clinical, endoscopic and histologicalcriteria. Disease activity was assessed according toHarvey–Bradshaw index (HBI) for CD and GlobalDisease activity index (Mayo) for UC.Mean HBI was 1.57 ± 1.23, range 0–4, while DAIwas constantly 0 points, except for two patients whohad Mayo 1 (0.07 ± 0.26). C-reactive protein (CRP)anderythrocytesedimentationrate(ESR)werewithinnormalvaluesbothinIBDandcontrols(TableI).IBDpatients were under medical treatment (salicylatesand/orazathioprine).Physicalexamination,laboratoryinvestigations,electrocardiography,ambulatorybloodpressure monitoring, ultrasound examination of thecarotid arteries (Intima-Media thickness [IMT]) andbrachialarteryFMDwereperformed,accordingtotheprotocol of our previous experience [4–6].Comparisons between groups were analyzed usingStudent’s t test for independent samples, ANOVAplus Neuman–Keuls. Frequencies were comparedusing chi-squared or Fisher’s exact test. ThePearson’s coefficient of correlation (R) was calcu-lated. Multiple regression analysis was then appliedto evaluate independent associations and confound-ing parameters.As reported in Table I, cases and controls were notsignificantly different, except for triglycerides levels