Increased pulse wave velocity and relationship with inflammation, insulin, and insulin resistance in inflammatory bowel disease

Eur J Gastroenterol Hepatol. 2014 Jul;26(7):725-32. doi: 10.1097/MEG.0000000000000104.

Abstract

Objective: Both ulcerative colitis and Crohn's disease are forms of inflammatory bowel disease (IBD), which is characterized by chronic, progressive inflammation of the gastrointestinal tract. Recent studies have shed new light on the importance of inflammation in the pathogenesis of arterial stiffness.

Aim: This study aimed to evaluate the relationship between pulse wave velocity (PWV) measurement and biochemical parameters in inactive and active IBD patients without cardiovascular risk factors and perform a comparison with the control group.

Materials and methods: We enrolled 102 IBD patients without cardiovascular risk factors and 74 matched controls, and evaluated each patient in active and inactive disease periods. All patients completed a standard questionnaire form and we assessed various laboratory parameters. We carried out vascular measurements using a Mobil-O-Graph 24-h pulse wave analysis monitor, an automatic oscillometric device.

Results: Although cardiovascular risk factors, such as total cholesterol and low-density lipoprotein cholesterol, were significantly lower (P<0.05) in IBD patients than the controls, 24 h, day and night PWV values, erythrocyte sedimentation rate, C-reactive protein, insulin, homeostasis model assessment of insulin resistance, and homocysteine were higher in patients with active and inactive IBD than the controls (P<0.05). Multiple linear regression analysis showed that PWV was correlated positively with age and duration of IBD.

Conclusion: This study showed increased PWV, homocysteine, erythrocyte sedimentation rate, C-reactive protein, insulin, and homeostasis model assessment of insulin resistance in patients with active and inactive IBD and provides evidence of the potential contribution of inflammation and inflammation-related factors toward arterial stiffening independent from conventional cardiovascular risk factors.

MeSH terms

  • Adult
  • Blood Flow Velocity / physiology*
  • Blood Sedimentation
  • Colitis, Ulcerative / epidemiology
  • Colitis, Ulcerative / metabolism
  • Colitis, Ulcerative / physiopathology*
  • Crohn Disease / epidemiology
  • Crohn Disease / metabolism
  • Crohn Disease / physiopathology*
  • Female
  • Homeostasis / immunology
  • Homocysteine / blood
  • Humans
  • Inflammation / epidemiology
  • Inflammation / metabolism
  • Inflammation / physiopathology
  • Insulin / blood*
  • Insulin Resistance / physiology*
  • Linear Models
  • Male
  • Middle Aged
  • Pulsatile Flow / physiology*
  • Risk Factors
  • Statistics, Nonparametric
  • Vascular Stiffness / immunology

Substances

  • Insulin
  • Homocysteine