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What Links an Increased Cardiovascular Risk and Inflammatory Bowel Disease? A Narrative Review
Liliana Łykowska-Szuber1, Anna Maria Rychter1, Magdalena Dudek2
1Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
Insights
Patients with inflammatory bowel disease (IBD) face higher cardiovascular disease (CVD) risks due to chronic inflammation, gut dysbiosis, and nutritional factors, not traditional risk factors. Understanding these links is crucial for managing CVD in IBD patients.
Area of Science:
- Gastroenterology and Cardiology
- Immunology and Nutrition
Background:
- Inflammatory bowel disease (IBD) is linked to increased cardiovascular disease (CVD) rates, including early atherosclerosis and myocardial infarction.
- Unlike the general population, IBD patients often lack traditional CVD risk factors, suggesting unique underlying mechanisms.
- Chronic inflammation, common to both IBD and CVD, involves shared physiopathological pathways.
Purpose of the Study:
- To review the factors contributing to elevated cardiovascular risk in IBD patients.
- To explore the roles of inflammation, nutrition, gut microbiota, and pharmacotherapy in CVD development within the IBD population.
Main Methods:
- Literature review focusing on inflammatory, nutritional, and microbiota-related factors.
- Analysis of physiopathological mechanisms linking IBD and CVD.
- Examination of dietary patterns and their influence on the IBD-CVD association.
Main Results:
- Elevated pro-inflammatory cytokines (e.g., C-reactive protein, homocysteine) in IBD contribute to endothelial dysfunction and CVD.
- Gut microbiota dysbiosis in IBD patients is identified as a risk factor for cardiovascular disease and atherosclerosis.
- Dietary factors significantly impact both IBD and CVD progression and their interrelationship.
Conclusions:
- Inflammatory, nutritional, and gut microbiota factors are key drivers of increased CVD risk in IBD patients.
- Further investigation into these specific factors is essential for effective CVD prevention and management strategies in IBD.
- Pharmacotherapy may also play a role in the complex interplay between IBD and cardiovascular health.
Abstract:
Several studies have shown increased rates of cardiovascular disease (CVD) in patients suffering from inflammatory bowel disease (IBD), particularly in cases of early atherosclerosis and myocardial infarction. IBD most frequently begins at an early age, patients usually present normal weight and remain under constant care of a physician, as well as of a nutritionist. Therefore, the classical risk factors of CVD are not reflected in the higher prevalence of CVD in the IBD population. Still, both groups are characterised by chronic inflammation and display similar physiopathological mechanisms. In the course of IBD, increased concentrations of pro-inflammatory cytokines, such as C-reactive protein (CRP) and homocysteine, may lead to endothelial dysfunctions and the development of CVD. Furthermore, gut microbiota dysbiosis in patients with IBD also constitutes a risk factor for an increased susceptibility to cardiovascular disease and atherosclerosis. Additionally, diet is an essential factor affecting both positively and negatively the course of the aforementioned diseases, whereas several dietary patterns may also influence the association between IBD and CVD. Thus, it is essential to investigate the factors responsible for the increased cardiovascular (CV) risk in this group of patients. Our paper attempts to review the role of potential inflammatory and nutritional factors, as well as intestinal dysbiosis and pharmacotherapy, in the increased risk of CVD in IBD patients.
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