Chronic systemic inflammation is associated with endothelial dysfunction in patients with ulcerative colitis (UC). The risk factors for endothelial damage include hypercholesterolemia, hyperhomocysteinemia, and increased levels of pro-inflammatory cytokines. The study of the reasons for endothelial dysfunction in patients with UC has diagnostic and prognostic value for curing patients and preventing cardiovascular pathologies.
OBJECTIVE
Establishing factors that influence the development of endothelial dysfunction in patients with UC.
MATERIAL AND METHODS
The study included 80 patients with UC. The lipid composition, homocysteine, E-selectin, VCAM-1, ICAM-1, C-reactive protein (CRP), TNF-α, and IL-6 levels were tested, and duplex scanning of extracranial vessels was carried out. The statistical indicators, including arithmetic mean and standard error of the mean; median, upper and lower quartiles; proportion and standard error of proportion; Mann—Whitney test; χ2 with Yates correction; and Fisher’s exact test, two-tailed, were calculated using the Statistica 10 software package.
RESULTS
The blood lipid composition did not exceed normal values in patients with UC. The triglycerides and very low-density lipoprotein (VLDL) values positively correlated with the content of pro-inflammatory cytokines (IL-6 and TNF-α). The correlation of the latter with high-density lipoprotein levels was negative. The levels of E-selectin and ICAM-1 positively correlated with the content of TNF-α and CRP. A correlation between the homocysteine level and IL-6 and TNF-α cell adhesion molecules was not revealed. Co-morbid patients with UC and arterial hypertension had an increased thickness of the intima-media complex and higher levels of triglycerides, VLDL, CRP, and TNF-α.
CONCLUSION
In patients with ulcerative colitis, systemic inflammation initiates endothelial dysfunction, while hypercholesterolemia and hyperhomocysteinemia do not produce such an effect.