Reactive hyperaemia index as a marker of endothelial dysfunction in children with Crohn's disease is significantly lower than healthy controls
Jehlicka Petr1, Huml Michal, Schwarz Jan
1Department of Paediatrics, Faculty Hospital, Pilsen, Czech Republic; Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic.
Insights
Children with Crohn's disease (CD) show signs of early cardiovascular issues. Lower reactive hyperaemia index (RHI) and higher inflammation markers indicate endothelial dysfunction (ED) and increased cardiovascular risk in pediatric CD patients.
Area of Science:
- Cardiovascular Health
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Inflammatory bowel disease (IBD) is linked to cardiovascular disorders, but data in children are limited and controversial.
- Assessing premature atherosclerosis in pediatric Crohn's disease (CD) requires further investigation.
Purpose of the Study:
- To evaluate endothelial dysfunction (ED) in children with CD using reactive hyperaemia index (RHI).
- To determine the extent of subclinical atherosclerosis in pediatric CD patients.
Main Methods:
- A study involving 21 children with CD and 12 healthy controls.
- Assessment of ED via plethysmographic RHI and biochemical markers.
- Diagnosis and disease activity measured by standard clinical, endoscopic, and histological criteria.
Main Results:
- Patients with CD exhibited significantly lower RHI values compared to controls (p < 0.05).
- Elevated levels of E-selectin, asymmetric dimethylarginine, and high-sensitive CRP were observed in CD subjects.
- Vascular cell adhesion molecule-1 did not show significant differences between groups.
Conclusions:
- Decreased RHI and elevated biochemical markers suggest systemic inflammation and ED in pediatric CD.
- Findings support the association between RHI, ED, and pediatric CD.
- Combined RHI and biochemical assessment may aid in detecting ED and stratifying cardiovascular risk in CD patients.
Aim:
Patients with inflammatory bowel disease (IBD) are prone to cardiovascular disorders, although there is little research to support this assertion, and other data are controversial in children. We aimed to determine the extent of premature atherosclerosis in Crohn's disease (CD) by measuring reactive hyperaemia index (RHI) as a functional marker of endothelial dysfunction (ED).
Methods:
Twenty-one patients with CD and twelve healthy matched subjects were enrolled in the study. Diagnosis was based on the standard clinical, endoscopic and histological criteria, including the Paediatric Crohn's disease Activity Index. ED was assessed using the plethysmographic RHI, combined with specific biochemical markers of ED.
Result:
RHI values were significantly lower in the patients with CD than the controls (p < 0.05). E-selectin (p < 0.05), asymmetric dimethylarginine (p < 0.01) and high-sensitive CRP (p < 0.05), but not vascular cells adhesive molecule-1 values, were significantly increased in the CD subjects compared with the control group.
Conclusion:
Significantly decreased RHI and elevated plasma levels of specific biochemical parameters seems to be related to systemic inflammation and ED in children with CD. Our results support the hypothesis regarding RHI and ED in paediatric CD. This combined method assessment might be a useful tool for detection of ED and stratification of cardiovascular risk in patients with CD.
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